A rare case of anatomical variation of the femoral artery and vein

During a dissection of the two femoral trigons in a female corpse, about 14 years old, we discovered on the right side, the deep artery of the thigh arising from the medial side of the femoral artery and passed in front of the femoral vein above the mouth of the great saphenous vein; on both sides, there was the presence of a collateral canal which communicated the external iliac vein with the femoral vein on the right, on the left, it communicated the external iliac vein with the quadricipital vein. The lower part of the femoral vein was duplicated on both sides, but on the right, there was an interconnecting channel between the two trunks of the duplication. Variations of the femoral vessels are very frequent and can be responsible for an incident during the practice of certain gestures at the level of the femoral trigon such as: catheterization of the femoral artery or vein, the treatment of femoral hernias. Key words: Deep thigh artery, collateral venous canal, external iliac vein, anatomic variations

Andean Pastures in the Fourth Region of Chile: Marginal Lands and Vital Spaces for a Transhumance System

In the fourth region of Chile, the high Andean pastures between Chile and Argentina are the summer destination for transhumant shepherds and sustain a part of the regional livestock. Since 2000, Chile has prohibited the passage of livestock to Argentina for animal health reasons in spite of official registers indicating that 60 to 75% of the summer transhumance livestock had an Argentine destination. Under those conditions it is questionable whether the Andean Chilean grasslands can absorb the increased pastoral demand without suffering damage. The objective is to provide elements of an answer to this question regarding the distribution and availability of the Andean forage resource and its modalities of explotation in the local transhumance system

Perceived water-related risk factors of Buruli ulcer in two villages of south-central Côte d'Ivoire

Background Buruli ulcer, caused by Mycobacterium ulcerans, is a neglected tropical skin disease that is primarily endemic in West and Central Africa, including Côte d'Ivoire. Studies indicate that M. ulcerans infections are caused by contact with an environmental reservoir of the bacteria, governed by specific human biological conditions. Yet, the nature of this reservoir and the exact mode of transmission remain unknown. Methodology To identify ecologic risk factors of Buruli ulcer in south-central Côte d'Ivoire, we pursued a qualitative study matched with geo-referencing inquiry. Embedded in a broader integrated wound management research project, we (i) mapped households and water sources of laboratory confirmed Buruli ulcer cases and (ii) interviewed 12 patients and four health care workers to assess exposure to surface water and to deepen the understanding of perceived transmission pathways. Principal findings Water availability, accessibility, and affordability were reported as key determinants for choosing water resources. Furthermore, perceived risks were related to environmental, structural, and individual factors. Despite the presence of improved water sources (e.g., drilled wells), communities heavily relied on unprotected surface water for a multitude of activities. The nearby Bandama River and seasonal waterbodies were frequently used for washing, bathing, and collection of water for drinking and cooking. Many residents also reported to cross the river on a daily basis for agricultural chores, and hence, are exposed to stagnant water during farming activities. Conclusions/significance Our study in two Buruli ulcer endemic villages in south-central Côte d'Ivoire revealed a wide range of water-related domestic activities that might expose people to an increased risk of contracting the disease. Environmental, biological, social, and cultural risk factors are closely interlinked and should be considered in future investigations of Buruli ulcer transmission. Active participation of the communities is key to better understand their circumstances to advance research and fight against Buruli ulcer and other neglected tropical diseases

Healthy aging: comparative analysis of local perception and diet in two health districts of Côte d'Ivoire and Japan

Context: Good health and longevity depend on dynamic interactions between biological, social, psychological, and environmental factors. Aging is globally a big challenge, particularly with the demographic transition, including population growth, and an emerging burden to society. Knowledge, behavior, diet, and consumption of animal source food were related to aging and emerged as the key factors modulating healthy aging. Objective: The study was designed to understand the main healthy aging factors, such as knowledge, social network, and diet of elders, and to derive mutual learning from it for healthy aging. Methods: A qualitative approach has been applied to explore health-related knowledge, attitude, and diet of elders from Ebetsu (Japan) and Tiassale (Cote d'Ivoire) health districts, using focus group discussions and comparative context analysis between high- and low-income countries. Results: The study shows that living longer is a common feature of people in Japan compared to Cote d'Ivoire, where the life expectancy is still low. Both groups of elders have social networks that support them, and both offer their gained experience to society. While Japanese elders depend on pension and insurance for income and medical treatments, Ivorians depend mostly on their children and social network in old age. The worries of elders differ between the two regions. In Ebetsu, elder members of the community are concerned about the future burden they pose for the younger generation if they develop ill-health, making them more resilient to aging. In Taabo, elders are considered to be culturally and socially useful to the society. Elders in Ebetsu pointed out that for healthy aging, education on diet at a younger age, physical activities, and access to basic social services are the key aspects. This was not observed in Taabo's context. Being inactive and dependent on others were described as the most worrying situations for elders in Ebetsu, as it is perceived to increase the risk of non-communicable diseases and anxiety. Elders in Ebetsu have good knowledge on what constitutes a healthy diet, and they believe that diversifying their diet, reducing portions, and substituting red meat with good animal and vegetable proteins are best eating practices to maintain good health. In Cote d'Ivoire, the diet is imbalanced and the whole family consumes the same meal made mainly with high-energy staples and little protein. However, it is observed in both societies that adopting a good diet is very expensive. Conclusion: The consciousness of aging is universal, but healthy aging varies according to the social systems, education, and knowledge on diet transition. Physical activities, protein-energy balance in diet, and social networks are the key for healthy aging in both contexts. The challenge is to find ways to increase knowledge regarding healthy aging and to strengthen the support system so that healthy aging becomes affordable

Etude épidémiologique, clinique et thérapeutique des hydrocèles dans trois districts sanitaires de la région de Sikasso/Mali: Epidemiological, Clinical and Therapeutic Study of Hydroceles in Three Health Districts in the Sikasso Region / Mali

Context and objective. Hydrocele is one of the most common urogenital manifestations of lymphatic filariasis. It is a common cause of enlarged scrotum in the tropics. This study aims to describe the epidemiological, clinical and therapeutic aspects of hydroceles. Methods. This cross-sectional descriptive study of hydroceles in three endemic filarial Sikasso areas in Mali was conducted from November 2017 to December 2018. The variables studied were: frequency of hydrocele, age of patients, duration of evolution, type of anesthesia, surgical technique, volume, operative time and postoperative results. Results. Three hundred fifty-eight patients were operated on in fourteen months. The frequency of hydrocele‘s surgery was 31%. Their average age was 47.1 years old (extremes 4 months and 94 years). The duration of evolution was 10.7 years (extremes 6 months and 21 years). The right side was the most affected with 44.1% followed by the left side with 31.3%. Hydrocele was bilateral in 19%. Local anesthesia (with xylocaine 2%) was used in 88%. All patients underwent a successful vaginal resection. Conclusion. The hydrocele remains a common urological pathology in these endemic areas. The diagnosis is made after a long period of evolution of the disease. Treatment in outpatient surgery is undertaken using local anesthesia. These hydrocele management campaigns should be encouraged to treat the maximum number of patients. Contexte et objectif. L’hydrocèle constitue l’une des manifestations urogénitales les plus fréquentes de la filariose lymphatique. Elle est une cause fréquente de grosse bourse dans les régions tropicales. L’objectif de cette étude est de décrire les aspects épidémiologiques, cliniques et thérapeutiques des hydrocèles. Méthodes. Il s’agissait d’une étude transversale et descriptive sur les hydrocèles, réalisée entre novembre 2017 et décembre 2018 ; dans trois zones endémiques filariennes dans la région de SIKASSO au Mali. Les variables étudiées étaient : la fréquence de l’hydrocèle, l’âge des patients, la durée d’évolution, le type d’anesthésie, la technique chirurgicale, le volume, le temps opératoire et les résultats postopératoires. Résultats. Trois cent cinquante-huit patients ont été opérés en quatorze mois. L’intervention de l’hydrocèle rendait compte de 31% des activités chirurgicales. Leur âge moyen était de 47,1 ans (extrêmes 4 mois et 94 ans). La durée d’évolution était de 10,7 ans (extrêmes de 6 mois et 21 ans). Le testicule droit était le plus touché (44,1 %) suivi du côté gauche (31,3%). L’hydrocèle était bilatérale dans 19 %. L’anesthésie locale à la xylocaïne 2 % a été réalisée dans 88%. La résection vaginale a été réalisée chez tous les patients avec succès. Conclusion. L’hydrocèle reste une pathologie urologique fréquente en zone d’endémie filarienne. Le diagnostic se fait après une longue durée d’évolution de la maladie. Le traitement en chirurgie ambulatoire réalisée sous anesthésie locale a montré des résultats satisfaisants. Ces campagnes de prise en charge de l’hydrocèle sont à encourager pour pouvoir traiter le maximum de patients

Sensitivity study of the regional climate model RegCM4 to different convective schemes over West Africa

Abstract. The latest version of RegCM4 with CLM4.5 as a land surface scheme was used to assess the performance and sensitivity of the simulated West African climate system to different convection schemes. The sensitivity studies were performed over the West African domain from November 2002 to December 2004 at a spatial resolution of 50 km × 50 km and involved five convective schemes: (i) Emanuel; (ii) Grell; (iii) Emanuel over land and Grell over ocean (Mix1); (iv) Grell over land and Emanuel over ocean (Mix2); and (v) Tiedtke. All simulations were forced with ERA-Interim data. Validation of surface temperature at 2 m and precipitation were conducted using data from the Climate Research Unit (CRU), Global Precipitation Climatology Project (GPCP) and the Tropical Rainfall Measurement Mission (TRMM) during June to September (rainy season), while the simulated atmospheric dynamic was compared to ERA-Interim data. It is worth noting that the few previous similar sensitivity studies conducted in the region were performed using BATS as a land surface scheme and involved less convective schemes. Compared with the previous version of RegCM, RegCM4-CLM also shows a general cold bias over West Africa whatever the convective scheme used. This cold bias is more reduced when using the Emanuel convective scheme. In terms of precipitation, the dominant feature in model simulations is a dry bias that is better reduced when using the Emanuel convective scheme. Considering the good performance with respect to a quantitative evaluation of the temperature and precipitation simulations over the entire West African domain and its subregions, the Emanuel convective scheme is recommended for the study of the West African climate system

Improvement of yam’s productivity by using human urine as fertilizer

L’alimentation des populations et la gestion des excréta constituent un défi majeur pour les pays en développement, notamment la Côte d’Ivoire. Il y a donc une nécessité d’améliorer les conditions de vie de cette population en exploitant les opportunités économiques qu’offrent les déchets, notamment l’urine. Dans ce sens, une étude sur la valorisation de l’urine en culture d’igname (Dioscorea cayenensis-rotundata) a été effectuée sur deux campagnes agricoles. Cette étude avait pour objectifs d’une part, d’évaluer les effets de l’urine sur la croissance, le développement et le rendement de l’igname et d’autre part, d’envisager les possibilités de stabiliser la production d’igname sur une même surface vu son exigence en fertilisant. Ainsi, un essai avec trois traitements (fertilisation à l’urine, fertilisation à l’engrais chimique et un témoin) a permis de montrer que les urines ont un effet significatif sur les paramètres de croissance (l’indice foliaire et la matière sèche totale) et le rendement en tubercules frais d’igname. En outre, la réplication du même essai sur le même site avec les mêmes traitements a montré que la production de l’igname demeure stable quand le sol est fertilisé à l’urine. L’urine est à promouvoir en culture d’igname pour préserver les végétations encore primaires et celles en friche vu sa forte demande et ses exigences en fertilisant

Effectiveness of four different interventions against Schistosoma haematobium in a seasonal transmission setting of Côte d'Ivoire: a cluster randomized trial

BACKGROUND: Annual mass drug administration (MDA) using praziquantel is the cornerstone of schistosomiasis morbidity control, but is not sufficient to interrupt transmission. We implemented a cluster-randomized trial to compare the effectiveness of four different intervention packages to interrupt transmission of Schistosoma haematobium in a seasonal transmission setting of Cote d'Ivoire. METHODS: Sixty-four localities with a S. haematobium prevalence in school children aged 13-14 years above 4% were randomly assigned to one of four intervention arms over a 3-year period: (1) the current standard strategy consisting of annual MDA before peak of transmission; (2) annual MDA after peak of transmission; (3) biannual MDA; and (4) standard MDA combined with snail control. The primary outcome was prevalence and intensity of S. haematobium infection in children aged 9-12 years 1 year after the final intervention, using urine filtration performed by experienced microscopists. RESULTS: By study end, we observed the lowest S. haematobium prevalence in the biannual MDA, compared to the standard treatment arm (0.6% vs. 7.5%; odds ratio [OR] = 0.07, 95% confidence interval [CI] = 0.02 to 0.24). The prevalence in arms 2 and 4 was about 3.5%, which was not statistically significantly different from the standard strategy (both ORs 0.4, 95% CI = 0.1 to ~1.8). New cases of infection were still observed in all arms at study end. CONCLUSIONS: Biannual MDA was the only regimen that outperformed the standard treatment. All strategies resulted in decreased prevalence of infection, however none of them was able to interrupt transmission of S. haematobium within a 3-year period