Implementation of active management of the third period of childbirth for the prevention of immediate post-partum bleeding in four regional maternity hospitals of Conakry, Guinea

Background: The objective of this study was to determine the frequency, skills level of health care service providers; to identify complications and difficulties related to the implementation of AMTPC/GATPA.Methods: It was about prospective study, descriptive of 6 months (1st March to 31st August 2014) carried out in the maternity hospitals of Faranah, Kindia, Mamou and Nzérékoré. It concerned the parturient women who had recently given birth and the personnel that carried out AMTPC/GATPA in these hospitals.Results: During the study period of 1,254 out of 1,305 births had benefited of AMTPC/GATPA, a frequency of 96.1%. The midwives were the most represented personnel in the implementation of GATPA (44.1%). In 46.4% of the cases, the health care service providers acquired this competence from the initial training. The release was obtained in the first trial in 64.9% cases. The duration of implementation of GATPA was less than 5 minutes in 72.6% cases. The different stages were respected in 91.5% cases. Complications were dominated by retention of placental fragments (10.2%). Lack of oxytocin was the main difficulty (36.6%).Conclusions: The sustainability of this achievement would depend on the systematic and correct implementation of AMTPC/GATPA at all childbirth attendants and the effective management of oxytocin

Évaluation des risques de pollution en métaux lourds (Hg, Cd, Pb, Co, Ni, Zn) des eaux et des sédiments de l’estuaire du fleuve Konkouré (Rep. de Guinée)

Au cours de cette étude nous avons mesuré les paramètres physicochimiques (T°C, pH, Salinité, oxygène dissous, turbidité) in situ par un appareil multi paramètre portatif HI 9828 Hanna et les teneurs en métaux lourds (cadmium, plomb, zinc, cobalt, nickel et mercure) ont été données par spectrométrie d’absorption atomique dans les eaux et les sédiments prélevés au mois d’avril. A la basse des résultats obtenus au niveau des paramètres physico-chimiques et chimiques mesurés dans l’eau et dans les sédiments, nous avons constaté une légère diminution de la salinité en avril, le pH est proche de la neutralité avec une faible mobilité des métaux et une élévation de la teneur de l’oxygène dissous et de la turbidité au niveau des stations K15 et K16 soumises aux influences directes des eaux marines oxygénées et des rejets des eaux usées du village de l’île Bokhinènè. Les teneurs des métaux lourds à l’exception du mercure et du cadmium qui ont des concentrations plus faibles dans les eaux et dans les sédiments sont élevées au niveau des stations de l’embouchure (K15 et K16); dans l’eau suivant l’ordre [Plomb (630µg/L)) > Cobalt (604µg/L) > Nickel (472µg/L) > Zinc (189µg/L)] et dans les sédiments suivant l’ordre [ Plomb (0,712µg/g) >Cobalt (0,665µg/g) > Nickel (0,616µg/g > Zinc (0,230µg/g), ], ce qui montre l’impact direct des déchets déversés au niveau de l’île de Bokhinènè, sur la qualité physico-chimique et métallique des eaux et des sédiments de l’estuaire.Mots-clés : pollution, eaux, métaux lourds, estuaire, Konkouré, Guinée.Risk assessment of heavy metal pollution (Hg, Cd, Pb, Co, Ni, Zn) in water and sediments of the river estuary (Rep. of GUINEA)During this study we measured physicochemical parameters (T ° C, pH, salinity, dissolved oxygen, turbidity) in situ by a multi parameter portable HI 9828 Hanna and concentrations of heavy metals (cadmium, lead, zinc, cobalt , nickel and mercury) were given by atomic absorption spectrometry in water and sediment collected in April. On the basis of results obtained at the physico-chemical and chemical measured in water and sediments, we found a slight decrease in salinity, pH is near neutrality with a low mobility of metals and elevated levels of dissolved oxygen and turbidity at stations K15 and K16 subject to the direct influence of oxygenated marine waters and discharges of wastewater from the village of the island Bokhinènè. The contents of heavy metals except mercury and cadmium concentrations were lower in the water and sediment are high at the mouth stations (K15 and K16) in water according to the order [Lead (630µg / L))> Cobalt (604µg / L)> Nickel (472µg / L)> Zinc (189µg / L)] and sediments in the order [Lead (0.712 mg / g)> Cobalt (0.665 mg / g)> Nickel (0.616 mg / g> Zinc (0.230 mg / g)] which leads us to believe the direct impact of the waste dumped at the island Bokhinènè on physic-chemical quality metal and water and sediment of the estuary.Keywords : pollution, heavy metals, water, sediments, estuary, Konkouré, Guinea

Prevalence and awareness of diabetes in Guinea: findings from a WHO STEPS

Aims: The aim of the present study was to determine the prevalence of diabetes, and to assess its awareness and related risk factors among adult Guineans.Methods: A population-based cross-sectional survey was conducted on 1 100  adults (46.6% women) aged 35–64 years from Lower Guinea, during September to December 2009, using the WHO STEPwise approach of surveillance of chronic  disease risk factors. Data were collected in three steps: demographic and  behavioural risk factors, blood pressure and anthropometric measurements, and fasting blood cholesterol and glucose testing. A multi-stage cluster sample design was applied to generate nationwide representative data.Results: The mean age of all participants was 47.3 years (SD 8.8), similarly in  Conakry, rural Lower Guinea and urban Lower Guinea. The prevalence of diabetes was 5.7% (95% CI 4.0–8.1). Among participants with diabetes, only 44.0% were aware of their status. In multivariable logistic regression analysis, determinants of diabetes prevalence were urban residency, male sex, age group 45–64 years, increased waist circumference, hypertension and hypercholesterolemia. Male sex, rural residency, age group 45–54 years, no formal education, waist circumference, hypertension and hypercholesterolemia were independent predictors of screen-detected diabetes.Conclusion: The present study found a high prevalence and low awareness of  diabetes, suggesting the need for appropriate actions to strengthen primary  healthcare approaches towards non-communicable diseases in Guinea.Keywords: Diabetes, epidemiology, Guine

Obstetric emergencies in the maternity ward of the Ignace Deen national hospital CHU of Conakry: sociodemographic, therapeutic and maternal fetal prognosis aspects

Background: Despite government efforts to reduce maternal mortality, the risk of a woman dying from obstetric complications is about one in six in the poorest regions of the world compared to one in thirty thousand in North Europe. The objective was therefore to describe the clinical socio-demographic aspects and to establish the maternal and fetal prognosis of obstetric emergencies.Methods: This was a descriptive cross-sectional prospective study over a 6-month period from January 1 to June 30, 2020 carried out at the maternity ward of the Ignace Deen national hospital (Conakry university hospital) in Guinea. The study looked at a continuous series of 662 obstetric emergency cases.Results: The frequency of admission of obstetric emergencies was 22.62%. They concerned young women (29.5 years old) on average, first-time mothers (53.32%), with low income professional activities, evacuated from a peripheral maternity unit (63.14%), no schooling (44.9%), married (92.3%), using the more often a means of public transport (66.5%) and whose pregnancies were poorly monitored (63.9%). Fetal emergencies were dominated by acute fetal distress (91.3%) and maternal emergencies were dominated by hypertensive emergencies (pre-eclampsia and eclampsia 37.44%) followed by hemorrhagic emergencies (last trimester hemorrhage and postpartum hemorrhage 34.34%). Pregnant and parturient women were more frequently admitted to labor (62.7%) and gave birth more frequently by caesarean section (86.70%). the staff reacted promptly to make a treatment decision in 75.5% of cases within fifteen minutes. emergency procedures were performed in less than fifteen minutes in almost all cases (97.4%), specific treatment was carried out in less than an hour in the majority of cases (68.3%). The maternal case fatality rate was 4.1% with the main cause of death being hemorrhagic shock of 51.8%. The stillbirth rate was 17.4%.Conclusions: The anticipation of emergency obstetric care (SOU) and close collaboration between the obstetrician, the anesthesiologist-resuscitator are essential in the management of obstetric emergencies

Features of <i>ESCHERICHIA COLI</i> samples from patients with diarrheal syndrome in the Republic of Guinea

Introduction. Diarrheal diseases are a global public health issue and cause 15% of deaths in children under 5 years old, of which about 80% occur in the regions of Africa and Southeast Asia. According to the Global Enteric Multicentre Study (GEMS) conducted in a number of African countries, one of the leading pathogens of high risk of death in infants and young children is diarrheagenic E. coli (DEC). In recent decades, antimicrobial resistance (AMR) has become globally ubiquitous. The Republic of Guinea urgently needs large-scale studies devoted to assessing DEC distribution and antibiotic resistance. The purpose of the study is to assess the pattern of E. coli infections and to test the susceptibility to antibiotics in strains of diarrheagenic E. coli sampled from individuals residing in the Republic of Guinea. Materials and methods. From 2019 to 2022, we studied 724 samples of faeces of patients with acute diarrhea, among them 72 (9.9%) children aged 1–5 years, 128 (17.7%) children aged 6–17 years, and 524 (72.4%) people aged 18 years and older; a method of polymerase chain reaction (PCR) was applied with the use of the AmpliSense® Escherichioses-FL reagent kit to identify the genetic determinants of DEC: EPEC, EHEC, ETEC, EIEC, and EAgEC (Central Research Institute of Epidemiology of Rospotrebnadzor, Russia). Susceptibility to 15 antimicrobial agents was found by the disc-diffusion method using Mueller–Hinton agar (Russia) and Oxoid discs (UK). Results were interpreted according EUCAST criteria, versions 2019–2022 (https://www.eucast.org/ast_of_bacteria/previous_versions_of_documents). Results. For the period from 2019 to 2022, the percentage of E. coli infections in the etiological pattern of acute intestinal infections amounted to 51.7%. In the age-related manner, DEC was significantly more common in young children aged 0–5 (96.9%, p 0.05) as compared to school age children aged 6–17 (53.9%) and adults (45.6%). In all years of observation, EAgEC strains prevailed, accounting for 38.4%. Other DEC pathotypes, EPEC, ETEC, EIEC and STEC, accounted for 27.2%, 17.5%, 11.8%, and 5.1%, respectively. DEC strains are susceptible to meropenem, amikacin, and nitrofurantoin. The activity of other antibiotics ranged from 11.3% for ampicillin, 28.3% for trimethoprim-sulfamethoxazole, and 34.0% for tetracycline to 73.6% for cephalosporins, 84.0% for aminoglycosides, and 98.1% for fluorinated quinolones. Conclusion. To reduce the burden of diarrheal diseases in the Republic of Guinea, it may be necessary to conduct targeted epidemiological and microbiological studies to identify DEC and monitor the development of antimicrobial resistance of E. coli infection pathogens in the population

Epidemio-clinical study of the first iterative cesarean in the gynecology-obstetric service at the teaching hospital of Cocody

Background: The iterative caesarean section, is a caesarean section that is performed on a uterus already healed, therefore for fear of maternal and perinatal risks, is recognized as one of the main causes of the inflation of caesarean section in the world. One in three caesarean sections is performed because of a scar uterus. Objective of this study was to analyse the epidemiological and clinical factors of iterative caesarean sections in the gynecology-obstetrics department at the Teaching Hospital of Cocody (Abidjan).Methods: This was a retrospective and descriptive study conducted from June 1st, 2018 to May 31st, 2019, including 349 iterative caesarean section cases.Results: The first iterative C-section accounted for 16.1% of the C-section indications during the study period. The average age of the patients was 30 years. Nearly half of the patients practiced in the informal sector 47.9%, were uneducated in 38.1% of cases and lived with a partner in 73.1% of cases. The majority of patients in this series 75.1% performed at least 4 ANCs. Patients were followed by prenatal visits in 61% of cases by midwives and in 8.6% of cases had an inter-reproductive space of less than 18 months. This study patients were evacuated in 46.4% of cases. Acute fetal distress was the first indication of first iterative caesarean section with 20.3% of cases. Emergency caesarean sections accounted for 84.4% of the cases in this series. Authors found maternal death 0.3% and 6.7% perinatal mortality.Conclusions: The iterative caesarean section is a caesarean section likely to cause difficulties and complications per- operative. Although in constant improvement the prognosis of the mother-child couple still remains a problem in this context, prenatal monitoring should be the prerogative of obstetrician gynecologists