Influence du tabagisme et du degré de dépendance nicotinique sur la capacité de réaction chez les footballeurs: The effects of smoking and the degree of nicotinic dependence on reaction time in football players

Context and objective. Data on the reaction capacity of the footballer in sub-Saharan Africa are scarce. This study aimed to evaluate the effects of smoking on athletes’ performance in the tasks of simple reaction time and choice. Methods. We conducted a prospective cohort study enrolling thirty footballer’s smokers and 28 non-smokers. All participants were asked to perform a cycloergometric test for 3 hours, five times a week. Degree of nicotinic dependence of smokers was evaluated by Fageström test. Before, and after this effort, the subjects undertook simple reaction time tasks and reaction time of choice. The performances were measured. Results. Compared to no smokers, smokers had significantly higher simple reaction time values: at rest, 280.9 ± 30.5 ms against 213.4±10.7 ms (p < 0.0001) and at recovery, 327.3±16.6 ms against 248.0±9.3 ms ms (p < 0.0001); in the reaction time of choice, the idle values were 475.5 ± 10.8 ms against 327.1 ± 8.3 ms ms (p < 0.0001) and at the recovery, 1.1±13.3 ms versus 290.7±7.6 ms ms (p <0.0001). Tobacco-dependent smokers had a higher reaction time compared to control subjects.  Conclusion. Footballer’s smokers exhibit higher simple reaction time values than non-smokers. Active smoking is absolutely incompatible with high-level sports. Contexte et objectif. Les données relatives à la capacité de réaction chez le footballeur en Afrique subsaharienne sont rares. La présente étude a évalué les effets du tabagisme sur les performances des sportifs dans les tâches de temps de réaction simple et de choix. Méthodes. Nous avons entrepris une étude de cohorte prospective enrôlant trente footballeurs fumeurs et 28 non-fumeurs. Tous les participants étaient invités à effectuer une épreuve cycloergométrique pendant 3 heures, cinq fois par semaine. Le niveau de dépendance nicotinique des fumeurs a été déterminé par le test de Fageström. Avant, au terme et au décours de cet effort, les sujets ont réalisé des tâches de temps de réaction simple et de temps de réaction de choix. Les performances ont été mesurées. Résultats. Comparés aux non-fumeurs, les fumeurs avaient des valeurs de temps de réaction simple significativement plus élevées: au repos, 280,9±30,5 ms contre 213,4±10,7 ms (p < 0,0001) et à la récupération, 327,3±16,6 ms contre 248,0±9,3 ms (p < 0,0001); au niveau du temps de réaction de choix, les valeurs au repos étaient de 475,5±10,8 ms contre 327,1±8,3 ms (p < 0,0001) et à la récupération, 441,1±13,3 ms contre 290,7±7,6 ms (p < 0,0001). Les fumeurs à grande dépendance tabagique présentaient un temps de réaction plus élevé par rapport aux sujets à faible dépendance. Conclusion. Le tabagisme actif est absolument incompatible avec la pratique sportive au haut niveau

Impact of national malaria control scale-up programmes in Africa: magnitude and attribution of effects

<p>Abstract</p> <p>Background</p> <p>Since 2005, malaria control scale-up has progressed in many African countries. Controlled studies of insecticide-treated mosquito nets (ITNs), indoor residual spraying (IRS), intermittent preventive treatment during pregnancy (IPTp) and malaria case management suggested that when incorporated into national programmes a dramatic health impact, likely more than a 20% decrease in all-cause childhood mortality, was possible. To assess the extent to which national malaria programmes are achieving impact the authors reviewed African country programme data available through 2009.</p> <p>Methods</p> <p>National survey data, published literature, and organization or country reports produced during 2000-2009 were reviewed to assess available malaria financing, intervention delivery, household or target population coverage, and reported health benefits including infection, illness, severe anaemia, and death.</p> <p>Results</p> <p>By the end of 2009, reports were available for ITN household ownership (n = 34) and IPTp use (n = 27) in malaria-endemic countries in Africa, with at least two estimates (pre-2005 and post-2005 intervals). Information linking IRS and case management coverage to impact were more limited. There was generally at least a three-fold increase in household ITN ownership across these countries between pre-2005 (median of 2.4% of households with at least one ITN) and post-2005 (median of 32.5% of households with at least one ITN). Ten countries had temporal data to assess programme impact, and all reported progress on at least one impact indicator (typically on mortality); in under-five year mortality rates most observed a decline of more than 20%. The causal relationship between malaria programme scale-up and reduced child illness and mortality rates is supported by biologic plausibility including mortality declines consistent with experience from intervention efficacy trials, consistency of findings across multiple countries and different epidemiologic settings, and temporal congruity where morbidity and mortality declines have been documented in the 18 to 36 months following intervention scale-up.</p> <p>Conclusions</p> <p>Several factors potentially have contributed to recent health improvement in African countries, but there is substantial evidence that achieving high malaria control intervention coverage, especially with ITNs and targeted IRS, has been the leading contributor to reduced child mortality. The documented impact provides the evidence required to support a global commitment to the expansion and long-term investment in malaria control to sustain and increase the health impact that malaria control is producing in Africa.</p

Variability in mortality following caesarean delivery, appendectomy, and groin hernia repair in low-income and middle-income countries: a systematic review and analysis of published data

Background Surgical interventions occur at lower rates in resource-poor settings, and complication and death rates following surgery are probably substantial but have not been well quantifi ed. A deeper understanding of outcomes is a crucial step to ensure that high quality accompanies increased global access to surgical care. We aimed to assess surgical mortality following three common surgical procedures—caesarean delivery, appendectomy, and groin (inguinal and femoral) hernia repair—to quantify the potential risks of expanding access without simultaneously addressing issues of quality and safety. Methods We collected demographic, health, and economic data for 113 countries classifi ed as low income or lower-middle income by the World Bank in 2005. We did a systematic review of Ovid, MEDLINE, PubMed, and Scopus from Jan 1, 2000, to Jan 15, 2015, to identify studies in these countries reporting all-cause mortality following the three commonly undertaken operations. Reports from governmental and other agencies were also identifi ed and included. We modelled surgical mortality rates for countries without reported data using a two-step multiple imputation method. We fi rst used a fully conditional specifi cation (FCS) multiple imputation method to establish complete datasets for all missing variables that we considered potentially predictive of surgical mortality. We then used regression-based predictive mean matching imputation methods, specifi ed within the multiple imputation FCS method, for selected predictors for each operation using the completed dataset to predict mortality rates along with confi dence intervals for countries without reported mortality data. To account for variability in data availability, we aggregated results by subregion and estimated surgical mortality rates. Findings From an initial 1302 articles and reports identifi ed, 247 full-text articles met our inclusion criteria, and 124 provided data for surgical mortality for at least one of the three selected operations. We identifi ed 42 countries with mortality data for at least one of the three procedures. Median reported mortality was 7·9 per 1000 operations for caesarean delivery (IQR 2·8–19·9), 2·2 per 1000 operations for appendectomy (0·0–17·2), and 4·9 per 1000 operations for groin hernia (0·0–11·7). Perioperative mortality estimates by subregion ranged from 2·8 (South Asia) to 50·2 (East Asia) per 1000 caesarean deliveries, 2·4 (South Asia) to 54·0 (Central sub-Saharan Africa) per 1000 appendectomies, and 0·3 (Andean Latin America) to 25·5 (Southern sub-Saharan Africa) per 1000 hernia repairs. Interpretation All-cause postoperative mortality rates are exceedingly variable within resource-constrained environments. Eff orts to expand surgical access and provision of services must include a strong commitment to improve the safety and quality of care

Traumatismes abdominaux chez l’enfant à propos de 37 cas au CHU de Brazzaville

diagnostiques et thérapeutiques des traumatismes abdominaux chez l’enfant. Il s’agissait d’une étude rétrospective descriptive et analytique de 37 dossiers d’enfants hospitalisés, de juillet 2010 à juin 2015, pour un traumatisme abdominal dans le service de chirurgie pédiatrique du CHU de Brazzaville.L’âge moyen était de 9 ans (extrêmes de 3 et 16 ans). Les traumatismes étaient surtout d’origine accidentelle dans 34 cas (91,9%), suivis de 2 cas (5,4%) de tentative d’autolyse par arme blanche et d’une rixe (2,7%). Les circonstances de survenue étaient dominées par les accidents de la voie publique (AVP) avec 14 cas (41,2%), suivi de la chute d’un arbre fruitier dans 7 cas (20,6%). Les contusions abdominales (CA) étaient prépondérantes avec 27 cas (73%) contre 10 cas (27%) de plaies abdominales énétrantes (PAP). Pour les contusions abdominales, le tableau clinique était dominé par un hémopéritoine dans 19 cas (51,3%); une lésion viscérale était retrouvée dans 19 cas dont 10 cas de rupture traumatique de la rate (RTR) ayant nécessité 7 splénectomies et 4 traitements conservateurs. Toutes les dix plaies abdominales étaient pénétrantes et explorées chirurgicalement. Une perforation d’organe creux a été noté dans 5 cas, une plaie épiploïque hémorragique dans 2 cas, un RTR dans un cas. Nous avons observé 1 cas (2,7%) de décès. En sommes, les accidents, notamment les AVP, sont les principaux pourvoyeurs de traumatismes abdominaux chez l’enfant. Les contusions abdominales sont prépondérantes, la rate est le viscère le plus souvent lésé et les splénectomies sont encore assez fréquentes dans notre pratique. Mots-clés: contusion, plaie, abdomen, rupture de la rate, enfant, Congo.Our objective was to determine the diagnostic and therapeutic aspects of abdominal trauma inchildren. It was a descriptive and analytical retrospective study of 37 cases of children hospitalized for abdominal trauma in the pediatric surgery department at the teaching hospital of the Brazzaville, from July 2010 to June 2015. The mean age was 9 years (range 3 to 16 years). Injuries were mostly accidental in 34 cases (91.9%), followed by 2 cases (5.4%) autolysis attempted stab and a brawl (2.7%). Accident of the public highway was the leading cause with 14 cases (41.2%), followed by a fall of a fruit tree in 7 cases (20.6%). Abdominal bruises were predominant, with 27 cases (73%) against 10 cases (27%) of abdominal wounds. In abdominal bruises, the clinical picture was dominated by a hemoperitoneum in 19 cases (51.3%), a visceral lesion was found in 19 cases of which 11 cases (40.7%) of spleen rupture traumatic requiring splenectomy 7. All ten were penetrating abdominal wounds and surgically explored: it was a hollow organ perforation in 5 cases of omental wound in 2 cases. We observed one case (2.7%) deaths.Accidents, particularly those involving of the public highway are the main suppliers of abdominal trauma in children. Abdominal bruising predominate, the spleen is the most commonly injured  organ and splenectomy are still quite frequent in our practice.Key words : bruise, wound, abdomen, ruptured spleen, child, Congo

Study of 9 Cases of Tuberculosis Pneumonia in Children at Chu of Brazzaville, Congo

In the Republic of Congo, a country where tuberculosis is endemic, there have not been many reports about tuberculosis pneumonia. This study aimed to describe the epidemiology, clinical features, and outcome of tuberculosis pneumonia in children. This was a retrospective study of 9 cases of children admitted from 2002 to 2015, that is, 0.7 cases per year. The average age was 37 months. The mean delay from the beginning of symptoms to the visit to a medical center was 36 days (range = 4-93 days). Physical examination indicated a pulmonary consolidation in 6 cases. Chest X-ray revealed a unilateral opacity in all cases. Sputum and gastric washing bacilloscopies were positive in all cases, and HIV serology was positive in 2 cases. Therapeutic observance was perfect and the evolution favorable. Tuberculosis pneumonia must be systematically proposed for children under 5 years of age, who present symptoms that are in contrast with the seriousness of chest X-ray injuries

Experiences Congolaises de la lutte contre l’obesite et l’inactivite physique par des programmes transdisciplinaires: Management of obesity and physical inactivity by transdisciplinar programs: Congolese experiments

Afin d’analyser les motifs de pratique des activités physiques et sportive chez les adultes congolais et d’évaluer l’impact de la marche athlétique sur la composition corporelle et le profil tensionnel, 1243 sujets dont 536 femmes ont pris part à cette étude analytique et observationnelle entre mai et août 2018. Il s’agissait d’adultes sains exerçant une activité professionnelle, d’âge moyen 46,6±10,3 ans. La détermination des motivations de pratique a fait recours à un guide questionnaire portant sur les choix d’activités, les caractéristiques des activités pratiquées et les motifs de pratique évoqués. En ce qui concerne les paramètres étudiés sur les effets de la marche athlétique, ils se résumaient au poids, le tour de taille, l’indice de masse corporelle, les pressions artérielles systolique, diastolique et moyenne. Les résultats obtenus ont révélé l’existence des motivations psychosociologiques en liaison avec la théorie d’accomplissement de Nicholls. Quant à la pratique de la marche athlétique, il a été observé une diminution significative de la pression artérielle systolique et moyenne au terme des 4 mois de conditionnement physique. En somme, la marche athlétique motivée par des choix liés à la santé s’avère bénéfique chez les personnes adultes en pleine activité professionnelle.ABSTRACTIn order to analyze the reasons for practice of the physical and sporting activities in the Congolese adults and to evaluate the impact of athletic walk on the body composition and the blood profile, 1243 subjects whose 536 women took part in this analytical and observational study between May and August 2018. These subjects were healthy adults practicing a trade, of mean age 46.6 ± 10.3 years. The determination of the motivations of practice made recourse to a guide bearing questionnaire on the choices of activities, the characteristics of the practised activities and the evoked reasons for practice. With regard to the parameters studied on the effects of athletic walk, they were summarized with the weight, the waist measurement, the index of body mass, the systolic blood pressure, diastolic blood pressure and average blood pressure. The results obtained revealed the existence of the psychosociological motivations in connection with the theory of achievement of Nicholls. As for the practice of athletic walk, ones observed a significant reduction in the systolic blood pressure and average blood pressure at the end the 4 months of physical conditioning. All things considered; the athletic walk moved by choices related to health proves to be beneficial at the adult people in full occupation