Incidence des infections du site opératoire en Afrique sub-saharienne: revue systématique et méta-analyse

Introduction: Les Infections du Sites Opératoire (ISO) sont à l’origine de morbi-mortalité et des dépenses supplémentaires en santé. Les pays en développement en sont les plus touchés. L’objectif était d’estimer l’incidence poolée des ISO en Afrique Sub-saharienne et décrire ses principaux facteurs de risque. Méthodes: Une revue systématique et une méta-analyse ont été effectuées à partir des bases de données de l’Organisation Mondiale de la Santé pour la Région Afrique, de PubMed et par recherche standard afin de sélectionner des articles électroniquespubliés entre 2006 et 2015. Seuls les articlestraitants de l’incidence et desfacteurs de risque des ISOdans les pays del’Afrique subsaharienneétaient retenus. Résultats: Sur 95 articles trouvés, 11 ont répondu aux critères d’inclusion. Seulement 9 pays sur les 45 y ont contribués avec une grandereprésentation du Nigéria (5 articles sur 11). L’incidence des ISO variaient de 6,8% à 26% avec une prédominance en chirurgie générale. L’incidence poolée des ISO était de 14.8% (IC à 95%: 15,5-16,2%), avec une importante hétérogénéité selon la spécialité et le mode de surveillance. Les facteurs de risque les plus citésétaient la longue durée d’intervention et la classe de contamination d’Altemeir 3 et 4. Les autres facteurs concernaient l’environnement hospitalier, les pratiques de soins inadéquats et les pathologies sous-jacentes. Conclusion: L’incidence des ISO est élevée en Afrique subsaharienne, des études dans cette région pourrait améliorer la connaissance, laprévention et la maitrise deces multiples facteurs de risques.Pan African Medical Journal 2016; 2

Knowledge, attitudes and practices of cervical cancer screening by health care providers in the Emana health area: Yaounde-Cameroon

Background: Gynaecological cancers and more particularly those of the cervix cause many victims in our country despite the many prevention tools that exist. The objective of this study was to assess the knowledge, attitudes and practices of providers on cervical cancer in the Emana health area.Methods: To achieve this objective, we conducted a cross-sectional study form the period from April 2nd to June 10th, 2019 in the health facilities of the Emana health area.Results: A total of 64 healthcare providers participated in the study, 03 gynecologists and obstetricians, 10 General practitioners, 30 state-certified nurses, 09 midwives, 12 nursing assistants. The majority of these providers had poor knowledge of the causes of the disease (25%), risk factors (34.4%), and means of prevention (39.1%), especially among state nurses (SRN), midwives, nursing assistants. (87.5%) had good knowledge of the clinical signs of the disease and were almost unanimous on the curability of this disease when discovered early (78.1%). The severity of the cancer was perceived by all; however, the practice of screening was low (10.9%). As for their personal screening practices, 73.1% (38/52) of female staff had never been screened.Conclusions: Even though the participants perceive the grave nature of the cervical cancer, the subsequent attitude and screening practices remain poor. The possible barrier to this is the insufficient continuous training and recycling of the health personnel. Emphasis should be laid on the methods of prevention of cervical cancer in the curricula of nurses and midwives in Cameroon

Initiatives to reduce postoperative surgical site infections of the head and neck cancer surgery with a special emphasis on developing countries

Introduction: Surgery in patients with head and neck cancers is frequently complicated by multiple stages of procedure that includes significant surgical removal of all or part of an organ with cancer, tissue reconstruction, and extensive neck dissection. Postoperative wound infections, termed ‘surgical site infections’ are a significant impediment to head and neck cancer surgery and recovery, and need to be addressed. Areas Covered: Up to 10-45% of patients undergoing head-and-neck cancers surgery develop SSIs. SSIs can lead to delayed wound healing, increased morbidity and mortality as well as costs. Consequently, SSIs need to be avoided where possible, as even the surgery itself impacts on patients’ subsequent activities and their quality of life, which is exacerbated by SSIs. Several risk factors for SSIs need to be considered to reduce future rates, and care is also needed in the selection and duration of antibiotic prophylaxis. Expert commentary: Head and neck surgeons should give personalized care, especially to patients at high risk of SSIs. Such patients include those who have had chemoradiotherapy and need reconstructive surgery, and patients from lower and middle-income countries and from poorer communities in high income countries who often have high levels of co-morbidity because of resource constraints

Incidence of surgical site infections in sub-Saharan Africa: systematic review and meta-analysis

International audienceINTRODUCTION: Surgical Site Infections (SSI) cause morbi-mortality and additional healthcare expenditures. Developing countries are the most affected. The objective was to estimate the pooled incidence of SSI in Sub-Saharan Africa and describe its major risk factors. METHODS: Systematic review and meta-analysis were conducted using the databases of the World Health Organization Regional Office for Africa, PubMed and standard search to select electronic articles published between 2006 and 2015. Only articles investigating SSI impact and risk factors in Sub-Saharan African countries were retained. RESULTS: Out of 95 articles found, 11 met the inclusion criteria. Only 9 countries out of 45 have contributed, with a huge amount of information coming from Nigeria (5 articles out of 11). The impact of SSI ranged from 6.8% to 26% with predominance in general surgery. The pooled incidence of SSI was 14.8% (95% CI: 15,5-16,2%) with significant heterogeneity according to the specialty and the method of monitoring. Most cited risk factors were long procedure length and categories 3 and 4 of Altemeier contamination class. Other factors included hospital environment, inadequate care practices and underlying pathologies. CONCLUSION: SSI incidence is high in Sub-Saharan Africa. Studies in this area could improve knowledge, prevention and control of these multiple risk factors

Blunt abdominal trauma with duodenal dissection: A case report

We describe a new case of duodenal wound with complete transection in a 22-year-old patient following a motorcycle accident. He presented to the emergency room of the rural Regional Hospital of Edéa in Cameroon with a clinical picture of acute abdomen and post-trauma hemodynamic instability. A peritoneal puncture brought back an incoagulable blood. An exploratory laparotomy revealed a large hemoperitoneum mixed with food debris. A tear of the omentum and transverse mesocolon and a complete section of the third duodenum at the beginning of its free portion were observed. The surgeon performed emergency closure of both duodenal stumps and performed an isoperistaltic lateral gastrojejunal bypass. A transfer to a specialized center for a more anatomical continuity was considered, but the imminence of a humanitarian mission in the hospital prompted the surgeon to seize the opportunity of this mission for the reoperation. This surgical revision was performed on the fifth postoperative day. A resection of the distal duodenal stump and the adjacent jejunal segment including the anastomosis was performed. Continuity was restored by a mechanical duodenal-jejunal anastomosis. The patient was discharged on the 18th postoperative day. This type of lesion is difficult to manage in an emergency situation in a structure with limited technical resources. Unfortunately, surgeons treating polytraumatized civilians are encountering an increasing number of blunt duodenal wounds requiring laborious management

Fully extraperitoneal laparoscopic inguinal hernia repair using conventional mesh versus tailor-made mosquito mesh: a randomized controlled trial from Cameroon.

No abstract availabl

Prospective, randomized clinical trial of laparoscopic totally extraperitoneal inguinal hernia repair using conventional versus custom-made (mosquito) mesh performed in Cameroon: a short-term outcomes.

Adverse economic conditions often prevent the widespread implementation of modern surgical techniques in third world countries such as in Sub-Sahara Africa.info:eu-repo/semantics/publishe

The Socio-Economic aspects of Laparoscopic Approach in the Treatment of Inguinal Hernia by Mesh in Cameroon

info:eu-repo/semantics/publishe