Management of Vesicouterine fistulae during fistulae surgical caravan in Cote d'Ivoire

Background: The urogenital fistula (UGF) which designate a solution of continuity between the urinary and genital tracts in women, are divided into several entities of variable gravity. The objective of this study was to describe the epidemiological, clinical and therapeutic characteristics of patients treated for vesicouterine fistula during ‘fistulas surgical caravans’.Methods: This was a prospective and descriptive study on a cohort of 34 patients treated for Vesico-uterine fistulae during ‘‘fistulas surgical caravans '' from 1st January 2012 to 31st December 2016.Results: Vesico uterine fistulae represented 2.1% of all urogenital fistulae treated. At the time of occurrence of fistulas, the average age of the patients stay was 33.3 years, and the majority was not educated (88.2%), lived in rural areas without occupations (73.5%). All the fistulae were secondary to childbirth, the majority of which took place on a scarred uterus (67.6%). And this childbirth responsible for the fistula was done by caesarean section in 97.7% of cases. Then the average duration of the fistula before management was 6 years. Finally, all the patients were operated by the same surgical technique, made by abdominal extra peritoneal transvesical way. The cure rate after this surgical technique was 97.1% (33 patients). The only case of failure required a second operation by another technique which permitted the healing of the patient.Conclusions: The vesicouterine fistulae were rare and the satisfactory results of their management invite us to sustain these surgical caravans and ensure their widespread

Efficiency of common washing treatments in reducing microbial levels on lettuce in Mali

Lettuce is one of the most cultivated vegetables (eaten raw) in Mali with a percentage of 69.4 amongst leafy vegetables and 30.4 of all vegetables. Vegetables consumed raw, particularly lettuce, are sources of foodborne pathogens. This study was conducted to assess bacterial contamination of unwashed lettuce and the efficiency of disinfecting it with tap water and varying concentrations of some chemical disinfectants: bleach (0.00285, 0.00570 and 0.00855 ppm), potassium permanganate (170, 340 and 510 ppm), vinegar (0.00285, 0.00570 and 0.00855 ppm) and common salt (500, 1000 and 1500 ppm) based on the three consecutive washing protocol recommended for vegetables in Mali. Lettuce samples were randomly selected from farms irrigated with untreated river water within communities five and six in Bamako. Lettuce leaves were exposed to low concentration of the chemical disinfectants at 15 min, intermediate at 10 min and high at 5 min. A bleach (0.00285 ppm)/vinegar (0.00285 ppm) combination disinfection was also tested at 15 min. Tap water, bleach, potassium permanganate, vinegar and common salt reduced faecal coliform populations by 1.3–2.9, 1.5–3.0 and 1.9–3.5 log CFU/100 g, at 5, 10 and 15 min, respectively. Disinfection treatment using bleach (0.00285 ppm) was found to be more effective than other disinfectants at all contact times. All the disinfectants reduced Escherichia coli populations by 2.0–2.8 log CFU/100 g on lettuce and completely eliminated Salmonella spp. at all treatment contact times. Disinfection treatment using bleach/vinegar combination at 15 min also reduced faecal coliform populations on lettuce by 2.8 log CFU/100 g and completely eliminated E. coli and Salmonella spp. All chemical disinfectants including tap water at 15 min reduced faecal coliform populations below the undesirable ICMSF (2011) level (1000 CFU/100 g wet weight). These could contribute to reduce the health risk associated with the consumption of lettuce in Mali

Les enjeux de la mise en œuvre des activités conjointes tuberculose et VIH dans les districts sanitaires de Bamako (Mali).

Introduction : Au Mali, le rapport du programme national de lutte contre la tuberculose (PNLT) révèle en 2015 que 541/4035 soit 13% des cas de tuberculose toutes formes dépistées sont infectées par le VIH. Le but de cette étude est de décrire le suivi biologique des patients co-infectés par le VIH et la tuberculose dans les communes de Bamako en période de crise et d’évaluer le niveau actuel de réalisation des activités conjointes TB/VIH recommandées au Mali. Méthodologie : Nous avons réalisé une étude rétro-prospective d’évaluation du niveau de réalisation des activités conjointes TB/VIH recommandées au Mali. La phase rétrospective a eu lieu de janvier 2012 à juin 2013 et celle prospective de Janvier à mars 2015 dans les communes de Bamako. Résultats : L’étude rétrospective a montré que la tuberculose est survenue chez 124 patients sur 4026 dépistés positifs au VIH soit un taux d’infection à tuberculose parmi les patients VIH+ de 2,95% de janvier 2012 à juin 2013. Le suivi biologique a été plus réalisé pour la tuberculose que le VIH chez les patients co-infecté avec un taux très faible de réalisation de la charge virale. L’étude prospective montre que le niveau de réalisation demeure faible pour la plupart des activités conjointes. Mais au plan pratique, seuls 2/10 agents enquêtés faisaient la prise en charge des deux pathologies selon les protocoles en vigueur en se basant sur les directives des chargés correspondant. Conclusion : Les mécanismes de collaboration des services intégrés de TB/VIH nécessitent d’être renforcés pour une meilleure réalisation des points inscrits dans le cadre stratégique des activités conjointes TB/VIH recommandées au Mali

Participatory Evaluation of Sorghum Processing and Sensory Attributes in Mali: Methodology for Improving Food Security Outcomes from Variety Development Efforts

A requirement for the successful development of new sorghum varieties in Mali is effective evaluation of grain qualities, since sorghum is a staple food crop on which farmers rely for food security. The diversity of grain quality and social aspects that determine varietal acceptability for processing and cooking, however, make this a challenging task. As the processors of sorghum grain in households, women’s knowledge of grain quality traits can contribute to this work. Our objective is to understand opportunities to use grain quality traits to identify experimental varieties that may contribute to food security. Culinary evaluations were conducted in nine villages across two sorghum production zones. Three teams of women, one per replicate, processed, cooked and evaluated five test varieties in each village. Sensory evaluations were conducted by 25 taste testers per village. The major varietal differences observed included the decortication losses, women’s appreciation for ease of processing, and consistency of the prepared food. The participatory evaluation of the quality testing results led to the development of the concept of ‘food yield’. Discussion of these results focuses on designing cost-efficient grain and food quality evaluations that rely on women’s expertise as processors and strengthens their role in the variety development process

Epidémiologie des cancers digestifs en milieu hospitalier à Bamako

Les cancers digestifs sont de plus en plus constatés dans nos régions, probablement du fait de la disponibilité plus importante des moyens diagnostiques. Le but principal de notre travail était d’étudier l’épidémiologie de ces affections dans les services d’hépato-gastro-entérologie et de chirurgie générale du CHU Gabriel Touré. Il s’agissait d’une étude transversale portant sur les patients hospitalisés de février à juin 2007 puis de février à juin 2008. Nous avons retrouvé 115 cancers digestifs sur 1 547 patients hospitalisés, soit une fréquence de 7,4 %. Le sex ratio était de 1,5 en faveur des hommes et l’âge moyen des patients était de 56,6 ± 2,4 ans. Les cancers de l’estomac et le CHC étaient plus fréquents avec respectivement : 59,1 % et 19,1 % des cas. Les femmes au foyer et les cultivateurs (couches socio-économiques défavorisées) étaient plus fréquemment atteints, avec respectivement 34,8 % et 33 % des cas. La salaison, la fumaison, la consommation de tabac, de tô (pâte cuite de céréale) avec potasse ont été les facteurs de risque les plus retrouvés dans respectivement 74,8 %, 80,9 %, 33,9 % et 99,1 % des cas. Les cancers digestifs constituent un véritable problème de santé publique.Digestive cancers are increasingly found in our regions, probably due to the greater availability of diagnosis facilities. The main goal of our work was to study the epidemiological aspects of these diseases in the hepatology and gastro intestinal tract unit and in the general surgery unit in the University hospital Gabriel Touré. It was a cross-sectional study about in-patient from February to June 2007 and from February to June 2008. We found 115 gastro-intestinal tract cancers among 1 547 in-patients (7.4%). The sex-ratio was 1.5 for men and the patient’s mean age was 56.6 ± 2.4 years. Gastric cancers and hepatocellular carcinoma were more frequent with 59.1% and 19.1% of the cases. Housewives and farmers (low incomes group) were more frequently affected with respectively 34.8% and 33% of the cases. Salt intake, smoking, chewing tobacco, tô (cereal dough with potash) consumption were the strongest risk factor found respectively in 74.8%, 80.9%, and 99.1% of the cases. Digestive cancer is thus a major public health concern

Capacitating Science-Policy dialogue platforms to trigger actions for accessing climate finance: experiences and lessons learnt from Ghana, Mali and Niger

Adequate financial resources are key barriers limiting the effectiveness and sustainability of the national science-policy dialogue platforms in West Africa. This Info Note documents the outcomes of and lessons learnt from capacity building activities to science-policy dialogue platforms in Ghana, Mali and Niger and how the capacity building program empowered the platforms and/or triggered actions for accessing climate finance. A structured engagement and capacity building approach was implemented to strength resource mobilization capacity of the science-policy dialogue platforms in Ghana, Mali and Niger. The approach has enabled the development of three GCF concept notes and two bilateral donor proposals for accessing climate finance. The structured engagement and capacity building approach adopted was instrumental in triggering actions. The strong commitment and leadership of the institutions hosting the secretariat of the platforms were also crucial in triggering action

Trends in malaria morbidity among health care-seeking children under age five in Mopti and Sévaré, Mali between 1998 and 2006

<p>Abstract</p> <p>Background</p> <p>In Mali, malaria is the leading cause of death and the primary cause of outpatient visits for children under five. The twin towns of Mopti and Sévaré have historically had high under-five mortality. This paper investigates the changing malaria burden in children under five in these two towns for the years 1998-2006, and the likely contribution of previous interventions aimed at reducing malaria.</p> <p>Methods</p> <p>A retrospective analysis of daily outpatient consultation records from urban community health centres (CSCOMs) located in Mopti and Sévaré for the years 1998-2006 was conducted. Risk factors for a diagnosis of presumptive malaria, using logistic regression and trends in presumptive malaria diagnostic rates, were assessed using multilevel analysis.</p> <p>Results</p> <p>Between 1998-2006, presumptive malaria accounted for 33.8% of all recorded consultation diagnoses (10,123 out of 29,915). The monthly presumptive malaria diagnostic rate for children under five decreased by 66% (average of 8 diagnoses per month per 1,000 children in 1998 to 2.7 diagnoses per month in 2006). The multi-level analysis related 37% of this decrease to the distribution of bed net treatment kits initiated in May of 2001. Children of the Fulani (Peuhl) ethnicity had significantly lower odds of a presumptive malaria diagnosis when compared to children of other ethnic groups.</p> <p>Conclusions</p> <p>Presumptive malaria diagnostic rates have decreased between 1998-2006 among health care-seeking children under five in Mopti and Sévaré. A bed net treatment kit intervention conducted in 2001 is likely to have contributed to this decline. The results corroborate previous findings that suggest that the Fulani ethnicity is protective against malaria. The findings are useful to encourage dialogue around the urban malaria situation in Mali, particularly in the context of achieving the target of reducing malaria morbidity in children younger than five by 50% by 2011 as compared to levels in 2000.</p

Diversity, dynamics, direction, and magnitude of high-altitude migrating insects in the Sahel

This is the final version. Available from Nature Research via the DOI in this record. Long-distance migration of insects impacts food security, public health, and conservation–issues that are especially significant in Africa. Windborne migration is a key strategy enabling exploitation of ephemeral havens such as the Sahel, however, its knowledge remains sparse. In this first cross-season investigation (3 years) of the aerial fauna over Africa, we sampled insects flying 40–290 m above ground in Mali, using nets mounted on tethered helium-filled balloons. Nearly half a million insects were caught, representing at least 100 families from thirteen orders. Control nets confirmed that the insects were captured at altitude. Thirteen ecologically and phylogenetically diverse species were studied in detail. Migration of all species peaked during the wet season every year across localities, suggesting regular migrations. Species differed in flight altitude, seasonality, and associated weather conditions. All taxa exhibited frequent flights on southerly winds, accounting for the recolonization of the Sahel from southern source populations. “Return” southward movement occurred in most taxa. Estimates of the seasonal number of migrants per species crossing Mali at latitude 14°N were in the trillions, and the nightly distances traversed reached hundreds of kilometers. The magnitude and diversity of windborne insect migration highlight its importance and impacts on Sahelian and neighboring ecosystems.Biotechnology and Biological Sciences Research Council (BBSRC)National Institutes of Health (NIH)U.S. Armylorida Department of Agriculture and Consumer Services-Division of Plant Industr

Diversity, dynamics, direction, and magnitude of high-altitude migrating insects in the Sahel

Long-distance migration of insects impacts food security, public health, and conservation–issues that are especially significant in Africa. Windborne migration is a key strategy enabling exploitation of ephemeral havens such as the Sahel, however, its knowledge remains sparse. In this first cross-season investigation (3 years) of the aerial fauna over Africa, we sampled insects flying 40–290 m above ground in Mali, using nets mounted on tethered helium-filled balloons. Nearly half a million insects were caught, representing at least 100 families from thirteen orders. Control nets confirmed that the insects were captured at altitude. Thirteen ecologically and phylogenetically diverse species were studied in detail. Migration of all species peaked during the wet season every year across localities, suggesting regular migrations. Species differed in flight altitude, seasonality, and associated weather conditions. All taxa exhibited frequent flights on southerly winds, accounting for the recolonization of the Sahel from southern source populations. “Return” southward movement occurred in most taxa. Estimates of the seasonal number of migrants per species crossing Mali at latitude 14°N were in the trillions, and the nightly distances traversed reached hundreds of kilometers. The magnitude and diversity of windborne insect migration highlight its importance and impacts on Sahelian and neighboring ecosystems

Intensifying Maize Production Under Climate Change Scenarios in Central West Burkina Faso

Combination of poor soil fertility and climate change and variability is the biggest obstacle to agricultural productivity in Sub-Saharan Africa. While each of these factors requires different promising adaptive and climate-resilient options, it is important to be able to disaggregate their effects. This can be accomplished with ordinary agronomic trials for soil fertility and climate year-to-year variability, but not for long-term climate change effects. In turn, by using climate historical records and scenario outputs from climate models to run dynamic models for crop growth and yield, it is possible to test the performance of crop management options in the past but also anticipate their performance under future climate change or variability. Nowadays, the overwhelming importance given to the use of crop models is motivated by the need of predicting crop production under future climate change, and outputs from running crop models may serve for devising climate risk adaptation strategies. In this study we predicted yield of one maize variety named Massongo for the time periods 1980–2010 (historical) and 2021–2050 (2030s, near future) across agronomic practices including the fertilizer input rates recommended by the national extension services (28 kg N, 20 kg P, and 13 kg K ha−1). The performance of the crop model DSSAT 4.6 for maize was first evaluated using on-farm experimental data that encompassed two seasons in the Sudano-Sahelian zone in six contrasting sites of Central West Burkina Faso. The efficiency of the crop model was evidenced by reliable simulations of total aboveground biomass and yields after calibration and validation. The root-mean-square error (RMSE) of the entire dataset for grain yield was 643 kg ha−1 and 2010 kg ha−1 for total aboveground biomass. Three regional climate change projections for Central West Burkina Faso indicate a decrease in rainfall during the growing period of maize. All the three scenarios project that the decrease in rainfall is to the tune of 3–9% in the 2030s under RCP4.5 in contrast to climate scenarios produced by the regional climate model GCM ICHEC-EC-Earth which predicted an increase of rainfall of 25% under RCP8.5. Simulations using the CERES-DSSAT model reveal that maize yields without fertilizer show the same trend as with fertilizer in response to climate change projections across RCPs. Under RCP4.5 with output from the climate model ICHEC-EC-Earth, yield can slightly increase compared to the historical baseline on average by less than 5%. In contrast, under RCP8.5, yield is increased by 13–22% with the two other climate models in fertilized and non-fertilized plots, respectively. Nevertheless, the average maize yield will stay below 2000 kg ha−1 under non-fertilized plots in RCP4.5 and with recommended mineral fertilizer rates regardless of the RCP scenarios produced by ICHEC-EC-Earth. Giving the fact that soil fertility improvement alone cannot compensate for the adverse impact of future climate on agricultural production particularly in case of high rainfall predicted by ICHEC-EC-Earth, it is recommended to combine various agricultural techniques and practices to improve uptake of nitrogen and to reduce nitrogen leaching such as the splitting of fertilizer applications, low-release nitrogen fertilizers, agroforestry, and any other soil and water conservation practices