Assainissement et Risque de Maladies des Populations en Commune VI du District de Bamako, Mali

L’urbanisation rapide et incontrôlée des villes africaines pose d’énormes difficultés d’accès aux infrastructures urbaines notamment celles liées à l’assainissement. L’absence de ce service de base engendre de mauvaises conditions d’hygiène, source de développement des germes pathogènes, responsables de nombreuses maladies. L’objectif de ce travail est d’analyser la relation entre l’absence ou les insuffisances du système d’assainissement et les risques sur la santé des populations en commune VI du District de Bamako. Après une revue des documents se rapportant sur le sujet, une enquête a été conduite auprès d’un échantillon de 329 ménages. Les informations collectées ont été saisies, traitées et analysées selon les méthodes de statistique descriptive. Il s’est assorti des tableaux simples et croisés, des graphiques qui ont été interprétés en fonction des besoins et des objectifs de l’étude. Les résultats issus des analyses ont montré qu’en CVI, il existe un déficit du système d’évacuation de déchets à travers leur mauvaise gestion et une mauvaise utilisation des poubelles. Cette situation s’accompagne de présence de risque de maladies. Toutefois, il s’avère que la question d’assainissement en CVI se pose avec acuité et engendre de réels problèmes de santé pour les populations. Il importe en effet de procéder à la réalisation de véritables infrastructures d’assainissement qui cadre bien avec l’évolution spatiale de la commune pour le bien-être des populations. Ces résultats serviront dans les prises de décisions afin de produire un meilleur cadre de vie aux populations de la Commune VI.   The rapid and uncontrolled urbanization of African cities have induced many problems of access to urban infrastructure, particularly those related to sanitation. The missing of this basic service leads to poor hygiene conditions, source of expansion of infective germs, responsible for many diseases. The objective of this research is to analyse the relationship between the absence or inadequate sanitation system and their risks to the health of the population of the commune VI (CVI) in Bamako District. After reviewing of literatures related to the subject, a survey was conducted with a sample of 329 households. The data collected was analysed using descriptive statistics methods. It was accompanied by simple and cross tables, graphs which were interpreted according to the needs and objectives of the study. The results showed that in CVI, there is a deficit in the waste disposal system through their mismanagement and of garbage cans. This situation is accompanied by the presence of a risk of disease. However, it turns out that the question of sanitation in CVI arises acutely and generates real health problems for the population. It is indeed important to carry out the construction of real sanitation infrastructures that fits well with the spatial evolution of the municipality for the well-being of the population. These results will be used in decision-making in order to provide a better living environment for the population of the CVI

Assainissement et Risques de Maladies dans la Commune vi du District de Bamako, Mali

L’urbanisation rapide et incontrôlée de la ville de Bamako pose d’énormes difficultés d’accès aux infrastructures urbaines notamment celles liées à l’assainissement. L’absence de ce service de base engendre de mauvaises conditions d’hygiène, source de développement des germes pathogènes, responsables de nombreuses maladies. L’objectif de ce travail est d’analyser la relation entre l’absence ou les insuffisances du système d’assainissement et les risques sur la santé des populations en commune VI du District de Bamako. Une enquête a été conduite auprès d’un échantillon initial de 329 ménages. Un tri a été faite pour sélectionner uniquement les ménages ayant déclaré des cas de maladie les 30 jours précédant les enquêtes. Les informations collectées auprès de ces ménages ont été saisies, traitées et analysées selon les méthodes de statistique descriptive. Les résultats issus des analyses ont montré que dans la Commune VI, il existe un déficit du système d’évacuation de déchets à travers leur mauvaise gestion et une mauvaise utilisation des poubelles. Cette situation s’accompagne de risques de maladies. Il importe en effet de réaliser de véritables infrastructures d’assainissement qui cadrent bien avec l’évolution spatiale de la commune pour le bien-être des populations. Ces résultats serviront dans les prises de décisions afin de produire un meilleur cadre de vie aux populations de la Commune VI.   The rapid and uncontrolled urbanization of Bamako city has induced many problems with access to urban infrastructure, particularly those related to sanitation. The missing of this basic service leads to poor hygiene conditions, a root for the development of many pathogenic germs and diseases. The objective of this research was to analyze the relationship between the absence or inadequacies of the sanitation system and the risks to the health of the populations in commune VI of the District of Bamako. A survey was conducted with an initial sample of 329 households. Sorting was done to select only the households having declared cases of illness in the 30 days preceding the surveys. The collected information from this household was entered, processed, and analyzed using descriptive statistics methods. The results showed that in the area, there is a deficit in the waste disposal system through the mismanagement and misuse of garbage cans. This situation is accompanied by the risk of disease. It is indeed important to create real sanitation infrastructures that fit well with the spatial evolution of the municipality for the well-being of the population. These results will be used in decision-making in order to produce a better living environment for the populations of Commune VI

Assainissement et Risque de Maladies des Populations en Commune VI du District de Bamako, Mali

L’urbanisation rapide et incontrôlée des villes africaines pose d’énormes difficultés d’accès aux infrastructures urbaines notamment celles liées à l’assainissement. L’absence de ce service de base engendre de mauvaises conditions d’hygiène, source de développement des germes pathogènes, responsables de nombreuses maladies. L’objectif de ce travail est d’analyser la relation entre l’absence ou les insuffisances du système d’assainissement et les risques sur la santé des populations en commune VI du District de Bamako. Après une revue des documents se rapportant sur le sujet, une enquête a été conduite auprès d’un échantillon de 329 ménages. Les informations collectées ont été saisies, traitées et analysées selon les méthodes de statistique descriptive. Il s’est assorti des tableaux simples et croisés, des graphiques qui ont été interprétés en fonction des besoins et des objectifs de l’étude. Les résultats issus des analyses ont montré qu’en CVI, il existe un déficit du système d’évacuation de déchets à travers leur mauvaise gestion et une mauvaise utilisation des poubelles. Cette situation s’accompagne de présence de risque de maladies. Toutefois, il s’avère que la question d’assainissement en CVI se pose avec acuité et engendre de réels problèmes de santé pour les populations. Il importe en effet de procéder à la réalisation de véritables infrastructures d’assainissement qui cadre bien avec l’évolution spatiale de la commune pour le bien-être des populations. Ces résultats serviront dans les prises de décisions afin de produire un meilleur cadre de vie aux populations de la Commune VI.   The rapid and uncontrolled urbanization of African cities have induced many problems of access to urban infrastructure, particularly those related to sanitation. The missing of this basic service leads to poor hygiene conditions, source of expansion of infective germs, responsible for many diseases. The objective of this research is to analyse the relationship between the absence or inadequate sanitation system and their risks to the health of the population of the commune VI (CVI) in Bamako District. After reviewing of literatures related to the subject, a survey was conducted with a sample of 329 households. The data collected was analysed using descriptive statistics methods. It was accompanied by simple and cross tables, graphs which were interpreted according to the needs and objectives of the study. The results showed that in CVI, there is a deficit in the waste disposal system through their mismanagement and of garbage cans. This situation is accompanied by the presence of a risk of disease. However, it turns out that the question of sanitation in CVI arises acutely and generates real health problems for the population. It is indeed important to carry out the construction of real sanitation infrastructures that fits well with the spatial evolution of the municipality for the well-being of the population. These results will be used in decision-making in order to provide a better living environment for the population of the CVI

Myasthenie auto-immune: diagnostic et prise en charge. A propos de six cas au Benin et au Gabon

La myasthénie est une maladie auto-immune qui se caractérise par une faiblesse musculaire fluctuante, s’aggravant à l’effort et s’améliorant au repos, mettant en jeu le pronostic vital. Le polymorphisme clinique de cette affection rend souvent le diagnostic clinique difficile. Aussi le dosage des anticorps anti récepteur d’acétylcholine (AC anti Rach) et l’ENMG sont les principaux outils du diagnostic. Les auteurs rapportent 6 cas de myasthénie pour mettre en relief les difficultés de diagnostic et de prise en charge en Afrique subsaharienne.Mots clés: Ac anti-Rach, Myasthénie, électromyogramme, AfriqueEnglish Title: Myasthenia autoimmune: diagnosis and management. About six cases in Benin and GabonEnglish AbstractMyasthenia is a life threatening autoimmune disease presenting varying degrees of muscle weakness becoming worse during effort and released by rest. Its clinical polymorphism makes difficult the diagnosis. The anti-AChR antibodies testing and EMNG are the main diagnostic tools. The authors report 6 cases of myasthenia to underline the difficulties regarding diagnosis and management of this disease in sub-Saharan Africa.Keywords: Anti-AChR antibodies, Myasthenia, Electromyogram, Afric

Un Cas de Lupus Erythemateux Dissemine (LED) Revele par une Anemie Chronique au Service d’hematologie Clinique du CHU de Yopougon

The authors report one case of systemic lupus erythematosus revealed by chronic anemia. This was a 29-year-old patient with long-term fever, chronic skin and joint lesions with isolated hypochrome microcytic haemolytic anemia on the hemogram. The diagnosis of SLE was made three years after the onset of symptomatology based on seven of the American Rheumatology Association's (ARA) criteria out of 11, including positive immunological status (antinuclear antibodies and native DNA). This observation shows the interest of evoking SLE, while looking for signs in a young woman with multiple and varied symptoms with signs of skin, kidney, osteoarticular and hematological disorders.Les auteurs rapportent un cas de lupus érythémateux disséminé révélé par une anémie chronique. IL s’agissait d’une patiente de 29 ans présentant une fièvre au long cours, des lésions cutanées et articulaires d’évolution chronique avec à l’hémogramme une anémie hémolytique isolée hypochrome microcytaire. Le diagnostic de LED a été retenu trois années après le début de la symptomatologie devant sept critères sur 11 de L’American Rheumatology Association (ARA) dont le bilan immunologique positif (anticorps antinucléaires et DNA natif). Cette observation montre l’intérêt d’évoquer le LED, tout en recherchant les signes chez une femme jeune présentant une symptomatologie multiple et variée avec les signes d’atteintes cutanée, rénale, ostéo-articulaire et hématologique

Subclinical Cardiac Dysfunction Is Associated With Extracardiac Organ Damages

Background: Several studies conducted in America or Europe have described major cardiac remodeling and diastolic dysfunction in patients with sickle cell disease (SCD). We aimed at assessing cardiac involvement in SCD in sub-Saharan Africa where SCD is the most prevalent.Methods: In Cameroon, Mali and Senegal, SCD patients and healthy controls of the CADRE study underwent transthoracic echocardiography if aged ≥10 years. The comparison of clinical and echocardiographic features between patients and controls, and the associations between echocardiographic features and the vascular complications of SCD were assessed.Results: 612 SCD patients (483 SS or Sβ0, 99 SC, and 19 Sβ+) and 149 controls were included. The prevalence of dyspnea and congestive heart failure was low and did not differ significantly between patients and controls. While left ventricular ejection fraction did not differ between controls and patients, left and right cardiac chambers were homogeneously more dilated and hypertrophic in patients compared to controls and systemic vascular resistances were lower (p < 0.001 for all comparisons). Three hundred and forty nine SCD patients had extra-cardiac organ damages (stroke, leg ulcer, priapism, microalbuminuria or osteonecrosis). Increased left ventricular mass index, cardiac dilatation, cardiac output, and decreased systemic vascular resistances were associated with a history of at least one SCD-related organ damage after adjustment for confounders.Conclusions: Cardiac dilatation, cardiac output, left ventricular hypertrophy, and systemic vascular resistance are associated with extracardiac SCD complications in patients from sub-Saharan Africa despite a low prevalence of clinical heart failure. The prognostic value of cardiac subclinical involvement in SCD patients deserves further studies

Evolution of Malaria Incidence in Five Health Districts, in the Context of the Scaling up of Seasonal Malaria Chemoprevention, 2016 to 2018, in Mali

International audienceContext: In Mali, malaria transmission is seasonal, exposing children to high morbidity and mortality. A preventative strategy called Seasonal Malaria Chemoprevention (SMC) is being implemented, consisting of the distribution of drugs at monthly intervals for up to 4 months to children between 3 and 59 months of age during the period of the year when malaria is most prevalent. This study aimed to analyze the evolution of the incidence of malaria in the general population of the health districts of Kati, Kadiolo, Sikasso, Yorosso, and Tominian in the context of SMC implementation.Methods: This is a transversal study analyzing the routine malaria data and meteorological data of Nasa Giovanni from 2016 to 2018. General Additive Model (GAM) analysis was performed to investigate the relationship between malaria incidence and meteorological factors.Results: From 2016 to 2018, the evolution of the overall incidence in all the study districts was positively associated with the relative humidity, rainfall, and minimum temperature components. The average monthly incidence and the relative humidity varied according to the health district, and the average temperature and rainfall were similar. A decrease in incidence was observed in children under five years old in 2017 and 2018 compared to 2016.Conclusion: A decrease in the incidence of malaria was observed after the SMC rounds. SMC should be applied at optimal periods

Prevalence of high-risk human papillomavirus genotypes in outpatient Malian women living with HIV: a pilot study

Abstract Introduction Long-term exposure to high-risk human papillomavirus (Hr-HPV) is a well-known necessary condition for development of cervical cancer. The aim of this study is to screen for Hr-HPV using vaginal self-sampling, which is a more effective approach to improve women’s adherence and increase screening rates. Methods This pilot study included a total of 100 Women living with HIV (WLWHIV), recruited from the Center for Listening, Care, Animation, and Counseling of People Living with HIV in Bamako. Hr-HPV genotyping was performed on Self-collected samples using the Cepheid GeneXpert instrument. Results The median age of WLWHIV was 44 (interquartile range [IQR], 37–50) years. Approximately 92% of the study participants preferred self-sampling at the clinic, and 90% opted to receive result notifications via mobile phone contact. The overall prevalence of Hr-HPV among study participants was 42.6%, and the most frequent Hr-HPV sub-types observed were HPV18/45 (19.1%), HPV31/35/33/52/58 (13.8%), and HPV39/68/56/66 (12.8%), followed by HPV16 (5.3%), and HPV51/59 (5.3%). WLWHIV under 35 years of age had a higher frequency of Hr-HPV compared to their older counterparts, with rates of 30% versus 11.1% (p = 0.03). The duration of antiretroviral treatment showed an inverse association with Hr-HPV negativity, with patients on treatment for 15 (IQR, 10–18) years versus 12 (IQR = 7–14) years for Hr-HPV positive patients (95% CI [1.2–5.8], t = 3.04, p = 0.003). WLWHIV with baseline CD4 T-Cell counts below 200 exhibited a higher frequency of Hr-HPV compared to those with baseline CD4 T-Cell counts above 200 (17.9% versus 1.9%, p = 0.009). However, other demographics and clinical factors, such as marital status, age of sexual debut, parity, education, history of abortion, history of preeclampsia, and cesarean delivery, did not influence the distribution of Hr-HPV genotypes. Conclusion Our findings indicate that WLWHIV under the age of 35 years old exhibited the highest prevalence of Hr-HPV infection, with HPV18/45 being the most prevalent subtype. Additionally, WLWHIV with baseline CD4 T-Cell counts below 200 showed the highest infection rates