L’epilepsie en milieu scolaire : enquete chez les enseignants de la ville de Kati au Mali et revue de la litterature

Introduction La prévalence de l’épilepsie en Afrique subsaharienne est élevée. Nous avons mené une étude transversale et descriptive dans l’ensemble des écoles primaires de la ville de Kati (200 000 habitants). Les enseignants furent interviewés de manière exhaustive à l’aide de questionnaires portant, d’une part, sur les connaissances, attitudes et pratiques des enseignants en matière d’épilepsie et, d’autre part, sur leurs avis sur les conséquences psychologiques, sociales pour l’enfant épileptique et les incidences sur sa scolarité.Résultats Nous avons interrogé 92 enseignants (60 hommes et 32 femmes). L’âge moyen des enseignants était de 30 ans. La majorité d’entre eux avait une expérience professionnelle de plus de 5 ans. Environ 38% des enseignants attribuaient la maladie à une cause surnaturelle. Plus de 39% des enseignants pensaient que l’épilepsie était contagieuse et 61% pensaient que l’épilepsie était incurable. 79% interdisaient systématiquement la pratique du sport à l’enfant épileptique. Environ 55% pensaient que l’enfant épileptique avait des capacités cognitives inférieures à celles de l’enfant non épileptique et 88% affirmaient que l’enfant épileptique était incapable d’avoir une scolarité normale. 59% trouvaient que l’élève épileptique était victime de stigmatisation et de marginalisation. Devant une crise, 68% renvoyaient l’enfant au domicile.Conclusion Ce travail fait apparaître un besoin de formation des enseignants en matière d’épilepsie. Les données actuelles sur la fréquence de l’épilepsie en milieu scolaire justifient une attention particulière des services de santé et de ceux de l’éducation nationale sur la scolarisation de l’enfant épileptique.Mots clés : Epilepsie, Ecole, Enseignants, Mali, Pratiques

Validating child vaccination status in a demographic surveillance system using data from a clinical cohort study: evidence from rural South Africa

<p><b>Background:</b> Childhood vaccination coverage can be estimated from a range of sources. This study aims to validate vaccination data from a longitudinal population-based demographic surveillance system (DSS) against data from a clinical cohort study.</p> <p><b>Methods:</b> The sample includes 821 children in the Vertical Transmission cohort Study (VTS), who were born between December 2001 and April 2005, and were matched to the Africa Centre DSS, in northern KwaZulu-Natal. Vaccination information in the surveillance was collected retrospectively, using standardized questionnaires during bi-annual household visits, when the child was 12 to 23 months of age. DSS vaccination information was based on extraction from a vaccination card or, if the card was not available, on maternal recall. In the VTS, vaccination data was collected at scheduled maternal and child clinic visits when a study nurse administered child vaccinations. We estimated the sensitivity of the surveillance in detecting vaccinations conducted as part of the VTS during these clinic visits.</p> <p><b>Results:</b> Vaccination data in matched children in the DSS was based on the vaccination card in about two-thirds of the cases and on maternal recall in about one-third. The sensitivity of the vaccination variables in the surveillance was high for all vaccines based on either information from a South African Road-to-Health (RTH) card (0.94-0.97) or maternal recall (0.94-0.98). Addition of maternal recall to the RTH card information had little effect on the sensitivity of the surveillance variable (0.95-0.97). The estimates of sensitivity did not vary significantly, when we stratified the analyses by maternal antenatal HIV status. Addition of maternal recall of vaccination status of the child to the RTH card information significantly increased the proportion of children known to be vaccinated across all vaccines in the DSS.</p> <p><b>Conclusion:</b> Maternal recall performs well in identifying vaccinated children aged 12-23 months (both in HIV-infected and HIV-uninfected mothers), with sensitivity similar to information extracted from vaccination cards. Information based on both maternal recall and vaccination cards should be used if the aim is to use surveillance data to identify children who received a vaccination.</p&gt

Hernies incisionnelles chez l’adulte dans un contexte sous médicalisé.

L’objectif de ce travail était d’étudier les facteurs favorisants et le traitement chirurgical des hernies incisionnelles. Il s’agissait d´une étude rétrospective descriptive portant sur des patients opérés pour hernie incisionnelle dans le service de chirurgie B du CHU du Point G sur une période de 11 ans allant du 1er janvier 2001 au 31 décembre 2011. Il a été enregistré 60 cas de hernies incisionnelles dont 40 femmes avec un sex-ratio de 0,5. L’âge moyen était de 39,8 ans ± 18,3. L’indice de masse corporelle moyen était de 26,3 kg/ m2. Les principaux facteurs favorisants qui étaient statistiquement liés à la survenue de la hernie incisionnelle ont été : âge jeune (≤ 45 ans), le sexe féminin, l’état nutritionnel, l’opération de la pathologie initiale en urgence, l’incision médiane et la longueur de l’incision initiale ≥ 5 cm. La cure a été une herniorraphie par suture aponévrotique dans 96,7% des cas (n=58), la mise en place d’une prothèse dans 3,3% des cas (n=2). Les suites opératoires étaient compliquées de suppuration pariétale dans 15% (n=9). Les récidives étaient de 13,3% des cas (n=8). Les facteurs favorisants de la hernie incisionnelle restent dominés dans notre contexte par les femmes jeunes, opérées en urgence par la laparotomie médiane, surtout sous ombilicale. La pariétorraphie est la technique chirurgicale la plus pratiquée.Mots clés : Hernie incisionnelle, facteurs favorisants, éventrations postopératoires, chirurgie

The identification of a complex A/G/I/J recombinant HIV type 1 virus in various West African countries

In this sequence note we describe the full-length genome sequence of an HIV-1 isolate originting from the West African country of Mali. The phylogenetic tree analysis from the near full-length genome shows that the 95ML84 strain forms a separate cluster, supported by 100% of the bootstrap values, with the previously described A/G/J/? mosaic virus BFP90 from Burkina Faso. Additional analysis showed that throughout the genome the lowest diversity was seen between the 95ML84 and the BFP90 viruses, and bootscan analysis showed a similar complex genomic structure. In addition to the initial report describing the BFP90 virus as an A/G/J/? recombinant, our data show that for the BFP90 and 95ML84 strains the unclassified region corresponds to subtype 1. The A/G/I/J BFP90 and 95ML84 strains represent the fifth and most complex circulating recombinant form of HIV-1 detected so far, and our data show its presence in various West African countries. Subtype 1 and J sequences, initially considered rare, seem to have broadened their geographical spread by way of these recombinant forms. (Résumé d'auteur

Analysis of the Physico-Chemical Conformity of Antibiotics: Case of Amoxicillin 500 mg Capsule at the National Health Laboratory Distributed in Health Structures in Mali

Introduction: Amoxicillin belongs to the family of β-lactams and is one of the mostly used in hospitals for the management of bacterial infections especially in Mali. It has a broad spectrum of activity from the group of aminopenicillins or aminobenzylpenicillins (group A penicillins). Microbiological and physico-chemical control has evolved with the development of biotechnology. All bacterial species or germs are affected by the phenomenon of resistance to antibacterials, which often poses real therapeutic problems. Based on previous studies in Mali, amoxicillin is still recommended in pharmacies and university hospitals to treat bacterial infections. It sometimes happens that patients are not satisfied with this amoxicillin-based prescription in our teaching hospitals. The objective of this study was to control the physico-chemical quality of amoxicillin 500 mg in capsule form. Methodology: This is a physico-chemical study of amoxicillin capsules dosed at 500 mg received at the National Health Laboratory in Bamako. We analyzed 10 batches of five (5) boxes (10 platelets/box) of amoxicillin. We used either HPLC, or TLC or Dissolu-test to control the quality of amoxicillin capsules for the presence of the active principle and to ensure fake amoxicillin capsules were not distributed. We used as reference, the standards contained in the pharmacopoeias in use. Results: The results of the physicochemical tests revealed that the samples analyzed complied with the standards of the Pharmacopoeias in use: The weight of our capsules was between 0.5g and 0.6g. All the tested samples were compliant with a disintegration time of 15 minutes at 37°C ±2°C. The peaks of standard amoxicillin and that of the tested samples appeared at substantially equal retention times, i.e. at 3.249 min and 3.248 min. respectively. Conclusion: Our work aimed to assess the quality of antibiotics used in Mali with the analytical means available at the LNS. All the batches of amoxicillin analyzed have not presented any cases of non-compliance so they can be distributed in health structures. This type of study should be extended to the other pharmaceutical forms of amoxicillin in the form of powders to be reconstituted dispensed in health centers in Mali. &nbsp