Soins Prénatals et Accouchement Assisté en Guinée

Des objectifs du millénaire pour le développement (OMD) aux objectifs de développement durable (ODD), la santé maternelle occupe une place importante. En Guinée, la situation sanitaire des femmes enceintes demeure une préoccupation majeure. En effet, le taux de mortalité maternelle se situait à 576 décès maternels pour 100 000 naissances vivantes en 2017. Les principales causes de cette mortalité maternelle élevée est la nonutilisation adéquate des services de soins prénatals ou l’absence d’assistance médicale à l’accouchement. L’objectif de cette étude est d’identifier les déterminants de la demande de soins prénatals, et de voir l’effet de ces soins sur l’accouchement assisté. Pour ce faire, les données utilisées sont celles de l’enquête démographique et de santé (EDS V). Elle a été conduite par l’institut national de la statistique (INS) avec l’assistance technique de la société ICF international. Cette étude utilise un modèle négatif binomial pour identifier les déterminants de la demande de soins prénatals, et une régression logistique pour voir l’effet de ces soins sur l’accouchement assisté. Les résultats montrent que les déterminants de la demande de soins prénatals sont : le niveau de vie du ménage, l’instruction de la femme et de son conjoint, le milieu de résidence, l’exposition de la femme à la télévision et la souscription à une assurance. Aussi, ils confirment l’effet positif des soins prénatals sur le recours à l’accouchement assisté. L’étude recommande la sensibilisation sur les avantages de la consultation prénatale et l’accouchement assisté sur la réduction de la morbidité et la mortalité maternelle. Aussi, la gratuité des consultations prénatales et la réduction des frais d’accouchement afin d’augmenter leurs utilisations. From the millennium development goals (MDGs) to the sustainable development goals (SDGs), maternal health occupies an important place. In Guinea, the health situation, particularly that of pregnant women, remains a major concern. The maternal mortality rate stood at 576 maternal deaths per 100,000 live births in 2017. Most of the medical causes of maternal mortality are the lack of adequate use of prenatal healthcare services or the lack of medical assistance at delivery. This paper aims at identifying the driving factors of the demand for antenatal healthcare and medical assistance at delivery. The study looks at the effect of antenatal healthcare on assisted childbirth in Guinea. The study used data from the 2018 wave of the demographic and health survey (DHS V) in Guinea conducted by the national institute of statistics (INS) with technical support from macro international. The paper employs a negative binomial model for the prenatal healthcare and a logit regression to assess the relationship between prenatal healthcare and assisted childbirth. The findings of the study indicate that the standard of living, education, residential milieu, exposure to women's media and insurance coverage are the most important determinants of the demand for antenatal healthcare. The results also confirm the positive effect of prenatal healthcare on the use of assisted childbirth. The paper recommends raising women's awareness of the advantages and benefits of prenatal consultation and assisted childbirth. Also, antenatal consultations should be made free of charge and delivery fees should be reduced to increase their use

Prophylactic and emergency cesareans: a comparative study on 718 observations at the maternity ward of Ignace Deen National hospital

Background: The objective of the study is to compare the frequency, the socio-demographic characteristics, the indications, the fetal maternal prognosis and the Robson classification of prophylactic and emergency caesarean sections.Methods: This was a comparative study of prophylactic and emergency caesarean sections at the maternity of Ignace Deen national hospital. It was a 12 month (July 1, 2016 to June 30, 2017) descriptive and analytical study.Results: Prophylactic caesarean sections accounted for 12, 51% of caesarean sections and 3.96% of deliveries at the ward. Prophylactic caesarean sections involved pregnant women aged from 20 to 29, holder of higher education degrees (51.54%), married (92.76%) employed (56.83%) and whose prenatal visit was provided by the obstetrician (73.54%). While the emergency caesarean section concerned parturient aged between 20 and 34, mostly non-schooled (36.49%), transferred patients (80.22%) and nulliparous (58.5%). Surgical indications were mainly scarred uterus (32.32%) and maternal pathologies (18.11%) prophylaxis; bleeding in the last quarter (25.90%) acute fetal distress (20.33%) in emergency. Groups 6 and 5 of the Robson classification were the most represented with a 2.23% morbidity and a zero maternal lethality in prophylaxis versus groups 5 and 6 with a 10.03% morbidity and a 1.67% maternal lethality in emergency.Conclusions: Improving this prognosis would be achieved through an increase in the frequency of prophylactic caesarean sections

Lake Satellite Temperature Data Validation

In environmental remote sensing, satellite data isn\u27t absolutely conclusive, for that reason, there is a natural need to verify the data acquired from the satellite. The most suitable tool to achieve such verification is on ground sensors that have the advantage of proximity. Addressing any possible discrepancies between the satellite data and the ground sensor data is sure to yield ways to come up with improvements of satellite band calibration and sensing capabilities. This research focused on correlating temperature data from the MODIS satellite with the data obtained from the In Situ sensor located in Lake Sunapee. Doing the latter proved that satellite data is still relatively loyal to the actual measurement on the ground; the RMSE for lake Sunapee is 3.8 K with a mean difference of 2.5 K. However, still more work needs to be done to address the marginal disparities from the two data sets

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

Surgical intervention on uterine fibromyoma in a country with limited resources: case of the gynaecology-obstetrics department of the Communal Medical Centre of Ratoma Conakry - Guinea

Background: In developing countries, treatment of uterine fibromyoma is confronted with numerous problems, namely: financial inaccessibility to the proposed treatments, fear of surgery and the weakness of the technical platform. The objectives of the study were to calculate the frequency of uterine fibromyomas, describe the socio-demographic characteristics of patients, identify the main clinical data and to describe the modalities of surgical management.Methods: It was a mixed descriptive study, cumulative over a period of 5 years (60 months) with data collection in two phases: a 4-year retrospective study from January 1, 2015 to December 31, 2018 and a 1-year prospective study from January 1, 2019 to December 31, 2019.Results: Authors collected 135 cases of uterine fibromyomas operated on out of a total of 260 cases of gynaecological pathologies, i.e. a frequency of 51.92%. Nulliparous women were the most concerned (45.18%), and women who attended school (60%) and those who did not attend school (40%). Women at home and housewives accounted for 42.20% and 54.07% respectively. Clinically, the circumstances of discovery were dominated by menometrorrhagia and menorrhagia respectively 77.77% and 68.14%. The large uterus was the most frequent physical sign found in 96.29% of cases. Uterine fibromyomas were recorded in 86.6% of cases in women with genital activity. The operative indications were dominated by the large polymyomatous uterus (64.44%), followed by hemorrhagic fibroma (18.52%) The surgical treatment was conservative in 92.60%. The total hysterectomy was performed in 7.40. Lethality was 1.4%.Conclusions: The surgical management of fibroids contrasts conservative treatment (myomectomy) with radical treatment (hysterectomy) with multiple possible approaches (hysteroscopy, vaginal surgery, laparoscopy or laparotomy). In this context, only laparotomy was possible due to lack of equipment. Laparoscopy and hysteroscopy equipment are necessary for less invasive surgery

Propagation du Lyssavirus chez les petits mammifères (Muridae et Soricidae) dans la Préfecture de Kindia, République de Guinée (Basse Guinée)

L’étude porte sur la propagation du Lyssavirus chez les petits mammifères dans la Préfecture de Kindia (Basse Guinée) a été réalisée entre avril 2015 et mars 2016 dans les différents biotopes (Maisons habitées, Forêts-Buissons, Champs agricoles, Entrepôts et Berges) et qui a pour objectif: Contribuée à l’amélioration de l’état de santé de la population. Pendant cette période d’étude, 412 rongeurs repartis en 12 espèces ont été capturées à savoir le rat d’herbe-Arvicanthis rufinus, les rats-Cricetomys gambianus, les rats-Crocidurinae spp., les souris rayées-Lemniscomys striatus, Lophuromys ansorgei, Lophuromys sikapusi, le rat à mamelles multiples-Mastomys spp., souris de maison-Mus musculus, Pelomys fallax, le rat de forêt-Praomys rostratus, le rat noir-Rattus rattus et le Malacomys edyardsi spp. Les plus répandus sont les Mastomys, Rattus rattus, Mus musculus et Cricetomys gambianus. En saison sèche, le nombre de rongeurs capturés dans la préfecture de Kindia a atteint 292 (71%) contre 120 (29%) rongeurs en saison pluvieuse. Pour des fins de recherches virologiques, le cerveau de 221 rongeurs a été prélevé et analysé parmi eux, 18 (8%) ont été trouvé porteurs de l’ARN de Lyssavirus. English title: Spread of Lyssavirus among small mammals (Muridae and Soricidae) in Kindia prefecture, Republic of Guinea (Lower Guinea) The study focuses on the spread of Lyssavirus among small mammals in the Prefecture of Kindia (Lower Guinea) was carried out between April 2015 and March 2016 in the different biotopes (inhabited houses, Forests-Bushes, Agricultural fields, Warehouses and Banks) and which has for objective: Contributed to the improvement of the state of health of the population. During this period, 412 rodents were caught in 12 species including the grass rat-Arvicanthis rufinus, the Cricetomys gambianus-rats, the Crocidurinae spp rats, striped mice Lemniscomys striatus, Lophuromys ansorgei, Lophuromys sikapusi, the multiple-teat rat-Mastomys spp., house mouse-Mus musculus, Pelomys fallax, forest rat-Praomys rostratus, black rat-Rattus rattus, and Malacomys edwardsi spp. The most common are: Mastomys spp., Rattus rattus, Mus musculus and Cricetomys gambianus. In the dry season, the number of rodents caught in the prefecture of Kindia reached 292 (71%) against 120 (29%) rodents caught during the rainy season. For virological research purposes, the brain of 221 rodents was collected and analyzed among them 18 rodents (8%) were found to carry Lyssavirus RNA

Etude de la pouzzolanicité de deux argiles de Kindia (Guinée) en vue de leur utilisation dans la formulation de liant hydraulique

This work presents, firstly, the results of pozzolanicity tests on two varieties of clay, codified respectively ABD and ARD, taken at Débélé. In a second step, the physical properties of the mortars obtained from these two clays by substitution of cement at a rate of 20% are presented and discussed. The mechanical behaviour of the mortars shows acceptable variations with apparent densities between 1.800 and 2.090 g/cm3. The mechanical resistance is lower than that of the control mortar for hybrids based on raw clays, but those of hybrids based on calcined clays are higher than that of the control mortar beyond the 28th. These results attest to the pozzolanic character of the Débélé clays and constitute a contribution to their valorisation in the formulation of hydraulic bindersCe travail présente, dans un premier temps, les résultats d’essais de pouzzolanicité de deux variétés d’argile, codifiées respectivement ABD et ARD, prélevées à Débélé. Dans un second temps, les propriétés physiques des mortiers obtenus à partir de ces deux argiles par substitution du ciment au taux de 20 % sont présentées et discutés. Le comportement mécanique des mortiers manifeste des variations acceptables avec des masses volumiques apparentes comprises entre 1,800 et 2,090 g/cm3. Les résistances mécaniques restent inférieures à celle du mortier témoin pour les hybrides à base d’argiles brutes, mais celles des hybrides à base d’argiles calcinées sont supérieures à celle du mortier témoin au-delà du 28ème. Ces résultats attestent le caractère pouzzolanique des argiles de Débélé et constituent une contribution pour leur valorisation dans la formulation des liants hydrauliques

Efficacité du rechargement de la plage de Pilote Bar (Saint-Louis) après une décennie d'érosion

L'ouverture d'une brèche dans la bande de sable de la Langue de Barbarie à Saint Louis (Sénégal) en 2004 a eu des conséquences sur l'étendue du bief fleuve-mer du Gandiolais. En effet, les zones en face de la brèche deviennent très vulnérables à l'action des vagues dévastatrices de la Grande Côte. La décision d'une protection douce par envasement a été prix pour protéger le village de Pilote Bar des risques d'érosion et de submersion marine. Cette première expérience au Sénégal a eu des résultats positifs. La recharge de la plage du Pilote Bar a favorisé la formation d'un lagon. Une sédimentation et une augmentation de la hauteur des pentes des plages voisines ont également été observées.Les courants mesurés par l'ADCP RIVER 1200 kW, présentent un fonctionnement normal caractéristique d'une zone fluvio-maritime.   This work presents the results of a morpho-dynamic and sedimentological monitoring after beach nourishment and the consecutive formation of a lagoon. Topographic measurements have allowed determining the origin of the sediments present in the lagoon. The movement of the sediments is from the high beach to the lagoon. The analysis of current velocities shows a normal functioning of a fluvio-maritime system with high velocities during the flood period and low velocities during the ebb. Particle size analysis shows that fine-grained sediments are deposited in the underwater part of the beach profile. This first experiment in Senegal had positive results. The recharging of the Pilote Bar beach has favoured the formation of a lagoon. Sedimentation and increase in the height of the slopes of the neighboring beaches were also observed. The currents measured by the ADCP RIVER 1200 kW, indicate a normal operation characteristic of a fluviomaritime zone

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

Study of the pozzolanicity of two clays from Kindia (Guinea) with a view to their use in the formulation of hydraulic binder

Ce travail présente, dans un premier temps, les résultats d’essais de pouzzolanicité de deux variétés d’argile, codifiées respectivement ABD et ARD, prélevées à Débélé. Dans un second temps, les propriétés physiques des mortiers obtenus à partir de ces deux argiles par substitution du ciment au taux de 20 % sont présentées et discutés. Le comportement mécanique des mortiers manifeste des variations acceptables avec des masses volumiques apparentes comprises entre 1,800 et 2,090 g/cm3. Les résistances mécaniques restent inférieures à celle du mortier témoin pour les hybrides à base d’argiles brutes, mais celles des hybrides à base d’argiles calcinées sont supérieures à celle du mortier témoin au-delà du 28ème. Ces résultats attestent le caractère pouzzolanique des argiles de Débélé et constituent une contribution pour leur valorisation dans la formulation des liants hydrauliques.This work presents, firstly, the results of pozzolanicity tests on two varieties of clay, codified respectively ABD and ARD, taken at Débélé. In a second step, the physical properties of the mortars obtained from these two clays by substitution of cement at a rate of 20% are presented and discussed. The mechanical behaviour of the mortars shows acceptable variations with apparent densities between 1.800 and 2.090 g/cm3. The mechanical resistance is lower than that of the control mortar for hybrids based on raw clays, but those of hybrids based on calcined clays are higher than that of the control mortar beyond the 28th. These results attest to the pozzolanic character of the Débélé clays and constitute a contribution to their valorisation in the formulation of hydraulic binder