Les causes de faillite des PME de l'Abitibi-Témiscamingue : cas des PME manufacturières de Rouyn-Noranda

Les petites et les moyennes entreprises (PME) constituent de nos jours des composantes essentielles du capitalisme fondé sur la propriété privée. À l'instar de la grande entreprise, les PME mettent au point les produits et les services que nous consommons, engagent des investissements, génèrent et redistribuent les revenus, créent de nouveaux emplois. Outil par excellence de la formation et de la valorisation du profit, l'entreprise est la cellule de base de l'économie de marché. Comme le précisent Ooghe et Van Wymeersch (2000), " l'entreprise est une organisation où des facteurs de production s'associent pour transformer des biens ou des services achetés (input) en biens et services d'une valeur supérieure (output), vendus à un prix accepté par le marché "· Plus concrètement, les PME s'avèrent incontournables pour dynamiser l'économie des pays de l'Organisation de coopération et de développement économiques (OCDE). Cette réalité s'applique également au Québec, tant dans les grands centres que dans les régions comme l'Abitibi-Témiscamingue. Or, malgré leurs rôles importants dans l'économie, ces PME sont confrontées à plusieurs difficultés les conduisant parfois à la faillite. Cet état de fait nous a amené à nous interroger sérieusement sur les causes de faillites des PME manufacturières assistées par la Société de développement des collectivités (SADC) et le Centre local de développement (CLD) de Rouyn-Noranda. C'est la question qui nous préoccupe tout au long de ce mémoire. Les réponses émanant de cet examen permettront de mieux comprendre et d'exposer le phénomène de faillite à travers les chapitres qui suivront, et surtout, de formuler des recommandations afin de le prévenir. D'abord, le chapitre 1 dresse un portrait socioéconomique de la région de l'Abitibi-Témiscamingue. Le chapitre 2 se consacre, pour sa part, à la recension des écrits et à la problématique tandis que le chapitre 3 définit les concepts clés de l'étude. Les chapitres 4 et 5 abordent respectivement le profil des entreprises défaillantes et les causes de la défaillance. Le chapitre 6 présente la méthodologie et met l'emphase sur l'utilité et le caractère novateur de cette étude. Quant au chapitre 7, il présente les résultats de l'étude. Finalement, les chapitres 8 et 9 exposent tour à tour la discussion et la conclusion

Fréquence des néphropathies congénitales au Centre hospitalier universitaire de Donka à Conakry: Frequency of congenital nephropathies in the University Hospital of Donka in Conakry

Context and objective. The real extent of congenital nephropathies is little known in Africa and in particular in Guinea. The objective of this study was to determine the prevalence of congenital nephropathies in the University Hospital of Donka. Methods. This was a descriptive retrospective study enrolling patients admitted for congenital nephropathy at both pediatric and pediatric surgery departments of Donka, between January 1st, 2007 and June 30th, 2012. The parameters of the study were epidemiological, clinical and paraclinical data.  Results. Of 34,448 patients recorded during the period studied, 26 had congenital nephropathies. They encompassed nephroblastoma (n=17), SJPU (n=6), hydronephrosis on left multikystic kidney (n=1), multikystic kidney in ptosis (n=1) and renal ectopia (n=1). Male sex was preponderant (21/26) with a sex ratio of 4.2/1. The 29 day-old to 2 year-old children were more affected. Conclusion. Congenital nephropathies appear less frequently in this hospital probably due to the absence of optimal facilities. The early diagnosis of congenital nephropathies should be made during the antenatal time, which would be a key to a better management of these conditions in affected children. Contexte et objectif. L’ampleur réelle des néphropathies congénitales est peu connue en Afrique et notamment en Guinée. L’objectif de cette étude était de déterminer la fréquence des néphropathies congénitales rencontrées. Méthodes. Cette étude documentaire de type descriptif sur la néphropathie congénitale, a été conduite entre les 1er janvier 2007 et 30 juin 2012, dans les services de pédiatrie et de chirurgie pédiatrique de Donka. Les paramètres d’interet englobaient les données épidémiologiques, cliniques et paracliniques.  Résultats. Parmi les 34.448 dossiers colligés, 26 présentaient une néphropathie congénitale. Il s’agissait des néphroblastomes (n=17), des syndromes de jonction pyélo-urétérale (n=6), d’une hydronéphrose sur rein multikystique gauche (n=1), d’un rein multikystique en ptose (n=1) et d’une ectopie rénale (n=1). Le sexe masculin était prépondérant (21/26) avec un sexe ratio de 4,2/1. Les enfants de 29 jours à 2 ans étaient les plus touchés. Conclusion. Les néphropathies congénitales sont paraissent moins fréquentes dans cette institution hospitalière, à cause du manque d’un plateau technique diagnostique optimal. Le diagnostic précoce des néphropathies congénitales devrait être fait dans la période prénatale ce qui permettrait une meilleure prise en charge des enfants affectés

Importance of screening for urinary tract infection in African Black diabetics

Urinary tract infections are common and often latent in diabetic patients. The objective of this study was to determinethe frequency of urinary tract infections and the organisms responsible.This is a descriptive type prospective study conducted in the Endocrinology and Diabetology ward of Donka UniversityHospital. All diabetic patients hospitalised from January 3rd to April 4th 2013 were included in the study.Two hundred and sixty-two diabetics had been screened, 64 (24.42%) had a urinary tract infection 41 women (64%)and 23 men (36%). The average age was 56.48 16.3 years with a range of 20-90 years. Urinary tract infections weremore frequent between the ages of 45 and 74 (67.20%). Sixty patients were married, four were single. Fifty-six patientswere type 2 diabetes against eight type I diabetes. Urine test strips showed 60 cases of pyuria, 36 cases of nitruria, 21cases of proteinuria and three cases of hematuria. Organisms identified were: Escherichia coli in 31 cases (48.43%): 25women and six men; Klebsiella pneumoniae in 14 cases (21.87%): nine women and five men; Staphylococcus aureusin 11 cases (17.18%): six women and five men; and Proteus mirabilis in eight cases (12.51%): two women and six men.The clinical manifestations were: asymptomatic bacteriuria in 57 cases (89.06%); acute cystitis in five cases (7.81%); andacute urethritis in two cases (3.13%).Urinary infection in African diabetics is very common. It requires a systematic screening with urine test strips becauseasymptomatic types are by far the most common. This would allow early treatment and avoid serious complications

Kidney failure screening in the general population of rural Africa

Kidney failure is a silently progressive disease too often unknown to the patients. The objective of this study was to assess the impact of kidney disease in Conakry so as to develop strategies for early detection and prevention.This was a descriptive-type prospective study carried out over six months, from January 31 to July 31, 2012. The study was carried out in two areas: In health facilities where the population were at a higher risk of developing kidney disease (diabetes, uropathies, infectious diseases and HIV, hypertension and cardiovascular disease), and in an apparently healthy population. In the study we included black subjects hospitalised in different targeted wards, as well as fully active apparently healthy subjects of the general population. Renal function was assessed with the simplified MDRD formula. Data collection included clinical parameters: Blood pressure, weight, height and blood laboratory parameters (creatinine, glucose) and urine (urine dipstick, 24h quantitative proteinuria).One hundred and ninety-nine patients were selected for the study: 117 men and 82 women ageing from 20 to 90 years. The prevalence of renal failure was 59% in the population at risk, with 53.3% of men and 16% in apparently healthy population with 60% of men with a statistically significant difference: p = 0.00000001. Proteinuria was observed in 86 patients in the population at risk against 19 in the healthy population

Services sociaux d'éducation et de santé en Guinée: Effets redistributifs de la politique gouvernementale

Cette étude a pour objectif d'identifier la progressivité des services publics d'éducation et de santé en Guinée, en s'appuyant sur les schémas de consommation tirés de l'enquête sur le niveau de vie de 2002-2003. Les résultats suggèrent que l'éducation publique primaire est plus progressive que l'éducation publique secondaire et universitaire, les consultations médicales et soins prénatals dans les centres et postes de santé sont mieux assurés que dans les hôpitaux. Cependant, on observe un biais anti-féminin dans la répartition des bénéfices tirés de la fourniture des services publics d'éducation. Ces résultats de recherche induisent la nécessité de rendre plus équitable l'accès aux services publics même si la taille du budget reste constante. Ils montrent aussi que, malgré la progressivité de l'éducation publique primaire et secondaire, l'expansion de leur couverture totale n'est pas une garantie pour l'amélioration de l'équité dans l'accès à ces services.Taux de couverture, incidence moyenne, incidence marginale, progressivité, dominance, courbe de concentration

Évaluation du Risque Cardiovasculaire Absolu Chez les Patients Hémodialysés Diabétiques et Non diabétiques au Centre National d’Hémodialyse de Donka Conakry

Le risque cardiovasculaire chez les hémodialysés semble varier en fonction du statut diabétique ainsi que d’autres facteurs associés et constitue un problème de santé publique en Afrique en général et particulièrement en Guinée. Dans ce sens, l’objectif de cette étude était d’évaluer le risque de survenue d’une pathologie cardiovasculaire absolu chez les patients hémodialysés diabétiques, par rapport aux patients hémodialysés non diabétiques. La présente, étude transversale, descriptive et analytique a été réalisée entre le 1 ier avril et le 30 juin 2019 au Centre National d’Hémodialyse de Donka. L’étude a inclus les 140 patients hémodialysés durant la période. Le recrutement était exhaustif et concernait tous les patients hémodialysés répondant aux critères de sélection. Les données ont été recueillies prospectivement chez les patients hémodialysés puis compilées et traitées dans Epi info. 7.2.2.6. Un questionnaire semi-administré a été utilisé à ce fin. Pour évaluer le risque cardiovasculaire chez les patients le FRAMINGHAM RISK SCORE (FRS) a été aussi utilisé. L’enquête a concerné 140 individus dont 91 (65,00%) étaient des hommes, contre 49 (35,00%) de femmes, soit un sex- ratio de 1,86 soit 2 hommes pour une femme. L’âge moyen était de 41 ± 4,1 ans avec des extrêmes de (30 ; 74) ans. On notait une prédominance chez les hommes des facteurs de risque, pour le tabagisme. L’étude a trouvé 39 diabétiques contre 101 non diabétiques. Le risque était élevé chez 23 diabétiquessur 39 ; et 25 sur 101 des patients non diabétiques. L’étude montre qu’un patient sur quatre aurait un risque absolu élevé chez les patients non diabétiques et un patient sur deux chez les patients diabétiques. Ce risque est majoré par d’autres facteurs associés. Introduction: Cardiovascular risk in hemodialysis appears to vary depending on diabetic status and other associated factors and is a public health problem in Africa in general and particularly in Guinea. The objective of this study was to assess the risk of absolute cardiovascular disease in diabetic hemodialysis patients, compared to non-diabetic hemodialysis patients. Methods: Between April 1 and June 30, 2019, a descriptive and analytical cross-sectional study was conducted at the National Hemodialysis Centre in Donka. The study included 140 hemodialysis patients during the period. Recruitment was comprehensive and involved all hemodialysis patients meeting the selection criteria. The data were collected prospectively in hemodialysis patients and then compiled and processed in Epi info. 7.2.2.6. A semi-administered questionnaire had been used. To assess cardiovascular risk in patients, FRAMINGHAM RISK SCORE (FRS) was used. Results: The survey involved 140 individuals, 91 of whom (65.00%) 49 (35.00%) were men. sex ratio of 1.86 or 2 men per woman. The average age was 41-4.1 years with extremes of (30; 74) years. There was a predominance among men of risk factors for smoking. The study found 39 diabetics versus 101 non-diabetics. The risk was high in 23 out of 39 diabetics; and 25 out of 101 non-diabetic patients. Conclusion: The study shows that one in four patients would have a high absolute risk in diabetic and non-diabetic patients and also confirms the association of other factors that increase this risk. The survey involved 140 individuals, 91 of whom (65.00%) 49 (35.00%) were men. sex ratio of 1.86 or 2 men per woman. The average age was 41-4.1 years with extremes of (30; 74) years. There was a predominance among men of risk factors for smoking and diabetes. In our series, most of our patients had a low risk level of 56 (40%). Conclusion: This survey finds a low risk in this hemodialysis population. This should lead to strengthening strategies for preventing cardiovascular disease in this at-risk population

Quantifying the value of viral genomics when inferring who infected whom in the 2014–16 Ebola virus outbreak in Guinea

Transmission trees can be established through detailed contact histories, statistical or phylogenetic inference, or a combination of methods. Each approach has its limitations, and the extent to which they succeed in revealing a 'true' transmission history remains unclear. In this study, we compared the transmission trees obtained through contact tracing investigations and various inference methods to identify the contribution and value of each approach. We studied eighty-six sequenced cases reported in Guinea between March and November 2015. Contact tracing investigations classified these cases into eight independent transmission chains. We inferred the transmission history from the genetic sequences of the cases (phylogenetic approach), their onset date (epidemiological approach), and a combination of both (combined approach). The inferred transmission trees were then compared to those from the contact tracing investigations. Inference methods using individual data sources (i.e. the phylogenetic analysis and the epidemiological approach) were insufficiently informative to accurately reconstruct the transmission trees and the direction of transmission. The combined approach was able to identify a reduced pool of infectors for each case and highlight likely connections among chains classified as independent by the contact tracing investigations. Overall, the transmissions identified by the contact tracing investigations agreed with the evolutionary history of the viral genomes, even though some cases appeared to be misclassified. Therefore, collecting genetic sequences during outbreak is key to supplement the information contained in contact tracing investigations. Although none of the methods we used could identify one unique infector per case, the combined approach highlighted the added value of mixing epidemiological and genetic information to reconstruct who infected whom

Determinants of Transmission Risk During the Late Stage of the West African Ebola Epidemic.

Understanding risk factors for Ebola transmission is key for effective prediction and design of interventions. We used data on 860 cases in 129 chains of transmission from the latter half of the 2013-2016 Ebola epidemic in Guinea. Using negative binomial regression, we determined characteristics associated with the number of secondary cases resulting from each infected individual. We found that attending an Ebola treatment unit was associated with a 38% decrease in secondary cases (incidence rate ratio (IRR) = 0.62, 95% confidence interval (CI): 0.38, 0.99) among individuals that did not survive. Unsafe burial was associated with a higher number of secondary cases (IRR = 1.82, 95% CI: 1.10, 3.02). The average number of secondary cases was higher for the first generation of a transmission chain (mean = 1.77) compared with subsequent generations (mean = 0.70). Children were least likely to transmit (IRR = 0.35, 95% CI: 0.21, 0.57) compared with adults, whereas older adults were associated with higher numbers of secondary cases. Men were less likely to transmit than women (IRR = 0.71, 95% CI: 0.55, 0.93). This detailed surveillance data set provided an invaluable insight into transmission routes and risks. Our analysis highlights the key role that age, receiving treatment, and safe burial played in the spread of EVD

Presentation of a case of Bruton type primary agammaglobulinemia in Guinea

X-linked agammaglobulinemia (XLA) is a rare genetic disease caused by a mutation in the Bruton tyrosine kinase (BTK) gene. It is characterized by a profound deficiency of B cells and a decrease in all classes of immunoglobulins (Ig). We report one case in a 3-year-old boy seen for recurrent acute otitis media, perineal abscess, oligoarthritis. The serum immunoglobulin (Ig) assay showed an IgG level of 0.6g/l. IgM and IgA are indosable. Marrow immunophenotyping showed an absence of precursor B less than 1%. Molecular biology confirmed Burton's disease (stop mutation, C37C) in exon 2 of the BTK gene. Treatment with intravenous immunoglogulin was started

Quality of life of patients with end-stage renal disease in Guinea

This questionnaire-based study included 69 patients from the Republic of Guinea with end-stage renal disease (ESRD) and was conducted over 12 months. The factors that affected their quality of life (QoL) were determined. The included ESRD patients had an estimated creatinine clearance (CCr) of <15 mL/minute using MDRD formula. We used the SF36 question-naire and classified the results into two groups: Scores <50/100 as poor QoL and scores 50/100 as good QoL. Factors that determined the QoL were cessation of all activities and additional effort required, severe or mild pain, good or bad health, and reduced or not reduced social and physical activities. Of the 69 patients, 32 (46.3%) had a good QoL and 37 (53.7%) had a poor QoL. The estimated CCr was similar in both groups. The average age of the poor QoL group was 54 ± 4 years, the good-QoL group′s average age was of 47.6 ± 4 years (P = 0.01). Patients with a good QoL had better overall health, but this was not statistically significant [OR = 0.42 (0.14-1.28); P = 0.14]. Patients with a poor QoL had more severe pain (P = 0.002); however, good QoL did not protect against mental problems [OR = 46.67 (8.18-351.97); P = 0.0001]. Mental status (P = 0.01) and social activities (P = 0.001) were reduced, and there were more comorbidities in the poor-QoL group (29.7%, with >4, P = 0.01). Good QoL was associated with younger age, fewer comorbidities, less severe physical pain, and fewer physical or social limitations. QoL could be increased by improving comorbidity treatments, giving more effective pain control, and providing more assistance for social and physical limitations