Zusammenarbeit zwischen Madagaskar und der Schweiz : die Umweltdimension

Vor dem Hintergrund des weltweiten Wettrennens um Wachstumsraten und der Bevölkerungsexplosion ist der Eintritt in das dritte Jahrtausend für die am wenigsten entwickelten Länder mit Schwierigkeiten verbunden. Die Umweltzerstörung, ein Resultat des Raubbaus an natürlichen Ressourcen, und die Verarmung der Bevölkerung dieser Länder sind für die Entwicklungsorganisationen zu einem wesentlichen Anliegen geworden. Sie sehen ihre Aufgabe darin, die Partner im schwierigen Lernprozess, der eine nach..

Zusammenarbeit zwischen Madagaskar und der Schweiz : die Umweltdimension

Vor dem Hintergrund des weltweiten Wettrennens um Wachstumsraten und der Bevölkerungsexplosion ist der Eintritt in das dritte Jahrtausend für die am wenigsten entwickelten Länder mit Schwierigkeiten verbunden. Die Umweltzerstörung, ein Resultat des Raubbaus an natürlichen Ressourcen, und die Verarmung der Bevölkerung dieser Länder sind für die Entwicklungsorganisationen zu einem wesentlichen Anliegen geworden. Sie sehen ihre Aufgabe darin, die Partner im schwierigen Lernprozess, der eine nach..

La coopération entre Madagascar et la Suisse : la dimension environnementale

Mes plus vifs remerciements vont à M. Kuno Schläfli (chargé de programme Madagascar à la Centrale de la DDC de 1993 à 1996) et à M. Philippe Zahner (coordinateur de la DDC à Madagascar de 1991 à 1996) qui ont bien voulu commenter à mon intention la littérature consultée et répondre à mes nombreuses questions. Ma gratitude leur est en outre acquise pour avoir accepté de revoir le texte. Dans un contexte mondial de course à la croissance et de démographie galopante, l’entrée des pays les moins ..

Early school leaving: obstetrical and neonatal risks

Introduction: Maternal mortality remains very high in Madagascar. In addition, women's education level is low. The aim of this study is to determine the impact of the maternal educational level on the obstetrical and neonatal outcomes.Methods: This is a retrospective analytical study of primiparae with seven years of study or less to patients with more than seven years of study at Zafisaona Gabriel Mahajanga university hospital center.Results: Prematurity was higher in low-grade patients (RR=2.6 (1.04-6.51)), and low birth weight was the leading cause of neonatal morbidity (RR=3.52). Pregnancy screening, maternal morbimortality, caesarean section, neonatal death and fetal intrauterine death were identical between the two groups.Conclusions: Education has a positive impact on maternal health. An education on pregnancy outcomes should be done at school

Twin Reversed Arterial Perfusion (TRAP) Syndrome or acardiac twin: a case report in Madagascar

TRAP syndrome is a rare complication of monochorionic twin pregnancy. It is characterized by the association of an acardiac twin with a healthy twin. The acardiac twin is a parasite who put the healthy twin at high risk of cardiac failure. We report a case in a 25-year-old Malagasy woman, primigravida, who had a consultation at gestational week 31 for significant dyspnea and a threat of premature delivery. Ultrasound scans discovered an acute polyhydramnios, fetus with anasarca and low cardiac activity, and a para-fetal mass. She gives birth to a male newborn and an acardiac twin without head an upper body. The first twin died short time after birth

Obstetrical and neonatal prognosis of a teenage primiparous pregnancy at the Zafisaona Gabriel Majunga university hospital center

Background: Women's fertility is early and high in Madagascar. Through this study, want to know the obstetric and neonatal risks in teenage primiparous pregnancies.Methods: Carried out a retrospective comparative study of teenage primiparous pregnancies who gave birth beyond 22 weeks of amenorrhea (SA) at the Zafisaona Gabriel Mahajanga university hospital between the period from January 1 to March 31, 2015. The control group is made up of first-time mothers aged 20 to 35 who gave birth in the same center.Results: The mean age of the patients was 16.77±1.12 years. In 43.1% of cases, the pregnancy was poorly followed. 22.41% of new-borns to adolescent mothers were hypotrophic at birth. Teenage primiparous pregnancies had a risk of poor pregnancy monitoring compared to their elders (RR: 2.17, 95% CI [1.35-3.47]) and a risk of giving birth to a low birth weight child (RR: 2.1, 95% CI [1.05-4.44]). The risk of preeclampsia, death in utero, caesarean section, instrumental extraction was identical between the two groups. Regarding the outcome of newborns, the frequency of premature birth, early neonatal infection, neonatal asphyxia, early neonatal death was not significant.Conclusions: Apart from fetal hypotrophy, adolescent girls have the same maternal, fetal and neonatal prognosis as their elders

The use of C-reactive protein in case of preterm labor with intact membranes

Background: Preterm labor, defined as delivery between 22 and 37WA, is the leading cause of perinatal morbidity and mortality. Through this study, we wanted to know if the high CRP rate in preterm labor with intact membranes could be a risk factor for poor prognosis on pregnancy and the newborn.Methods: We conducted a prospective cohort study from November 1, 2018 to April 31, 2019 at Befelatanana University Hospital of Gynecology-Obstetrics on singleton pregnancies with preterm labor and intact membranes. The population is divided in two groups according to the rate of CRP and we have chosen as a pathological threshold a CRP ≥7 mg/l.Results: We included 71 cases of MAP over 1735 births, or 4.09%, of which 47% had a CRP≥7mg / l (group I) and 51% a CRP <7mg / l (group II). There was a significant difference in the persistence of uterine contraction after 48h of tocolysis in group I and II [p = 0.0013, RR 5.20 (1.63-16.55)] as well as within of delivery (7.68±5.33 versus 21.36±11.30 days, p <0.05). There was no difference in the occurrence of neonatal asphyxia and neonatal infection between the 2 groups. However, the risk of prematurity is high in the group with a high CRP level [RR 1.34 (1.06-1.70)] (p = 0.02).Conclusions: In the case of preterm labor with intact membrane, CRP is a determinant of delivery delay, failure of tocolysis, and occurrence of preterm delivery

Epidemiology of maternal mortality in Befelatanana maternity during 2016-2017

Background: Maternal mortality remains a permanent obsession for the pregnant woman and her entourage, and is still one of the topical issues faced by a developing country, such as Madagascar. Our study aims to determine the epidemiological and etiological profile.Methods: We conducted a descriptive retrospective study over a 2-year period from January 1st, 2016 to December 31st, 2017 at the Befelatanana Gynecology-Obstetrics Hospital on maternal deaths.Results: We had 76 maternal deaths out of 5430 births, or 1.39%. The average age was 31.18±8.38 years with extremes of 14 and 49 years. The average parity was 2.67±1.85. The majority of pregnancies were poorly followed with a mean ANC of 2.18±1.85. The referred patients predominated at 68.42%. Women living in the urban area had a 57.89% majority. Among the etiology, hypertensive complications predominated at 42.11% followed by hemorrhagic (38.16%) and infectious (19.14%) complications. The patients who underwent surgery predominated at 78.94% and 59.21% were transfused.Conclusions: Maternal mortality remains a major concern at the Befelatanana Obstetrics Gynecology Hospital. During our study, hypertensive complications were found to be the most common causes requiring adequate management. For this, an awareness of pregnant women for the standardization of ANC, as well as regular training of health actor are necessary