Prévalence et facteurs associés aux accidents domestiques chez les enfants de 0 à 59 mois à Bamako (Mali) en 2017: Prevalence and factors associated with domestic accidents among children aged 0-59 months in Bamako, Mali in 2017

Introduction : Dans le monde, 90% des traumatismes chez les enfants se produisent domicile ou à proximité. L’objectif de cette étude était de déterminer la prévalence et d’identifier les facteurs associes des accidents domestiques chez les enfants de moins de 0 à 59 mois à Bamako en 2017. Méthodes : Une étude transversale descriptive et analytique a été conduite du 1er février au 31 mars 2017 e Bamako. Un sondage en grappe a été réalisé. Les mères ou tuteurs d’enfants ont été interviewés au moyen d’un questionnaire. Une fiche d’observation des domiciles a aussi été utilisée. Résultats : Au total, 630 enfants de 0 à 59 mois ont été inclus dans l’étude. Leur âge médian était de 24 mois (Intervalle interquartile (14 mois a 36 mois)) et le ratio femmes/hommes de 1,01. La prévalence des accidents domestiques était de 11,2% (Intervalle de confiance a 95% (9,03-13,98)). Les types d’accidents étaient les brulures, chutes, morsures, intoxications, étouffements et noyades. En analyse multivariée, les caractéristiques sociodémographiques des enfants associes aux accidents domestiques étaient : l’âge ≥ 24 mois (ORa = 1,90; p = 0,02) et le sexe masculin (ORa = 1,97; p = 0,01). Conclusion : La prévalence des accidents domestiques était de 11,2% chez les enfants de 0 à 59 mois à Bamako. Les accidents domestiques survenaient très souvent chez les garçons de 24 mois et plus. La surveillance domestique des garçons de 24 à 59 mois devrait être renforcée a Bamako. Introduction: Worldwide, 90% of childhood injuries occur in or near the home. The objective of this study was to determine the prevalence and identify associated factors of home accidents in children under 0-59 months in Bamako in 2017. Methods: A descriptive and analytical cross-sectional study was conducted from 1 February to 31 March 2017 in Bamako. A cluster survey was conducted. Mothers or guardians of children were interviewed using a questionnaire. A home observation form was also used. Results: A total of 630 children aged 0-59 months were included in the study. Their median age was 24 months (interquartile range (14 months-36 months)) and the sex ratio female/male was 1.01. The prevalence of domestic accidents was 11.2% (95% confidence interval (9.03-13.98)). The types of accidents were burns, falls, bites, poisoning, choking and drowning. In multivariate analysis, the socio-demographic characteristics of children associated with domestic accidents were: age ≥ 24 months (ORa = 1.90; p = 0.02) and male gender (ORa = 1.97; p = 0.01). Conclusion: The prevalence of domestic accidents was 11.2% among children aged 0-59 months in Bamako. Domestic accidents occurred most frequently in boys aged 24 months and over. Domestic surveillance of boys aged 24-59 months should be reinforced in Bamako. &nbsp

Direct and indirect costs of diabetes mellitus in Mali: A case-control study.

Diabetes mellitus (DM) is one of the most burdensome chronic diseases and is associated with shorter lifetime, diminished quality of life and economic burdens on the patient and society as a result of healthcare, medication, and reduced labor market participation. We aimed to estimate the direct (medical and non-medical) and indirect costs of DM and compare them with those of people without DM (ND), as well as the cost predictors.Observational retrospective case-control study performed in Mali. Participants were identified and randomly selected from diabetes registries. We recruited 500 subjects with DM and 500 subjects without DM, matched by sex and age. We conducted structured, personal interviews. Costs were expressed for a 90-day period. Direct medical costs comprised: inpatient stays, ICU, laboratory tests and other hospital visits, specialist and primary care doctor visits, others, traditional practitioners, and medication. Direct non-medical costs comprised travel for treatment and paid caregivers. The indirect costs include the productivity losses by patients and caregivers, and absenteeism. We estimate a two-part model by type of service and a linear multiple regression model for the total cost. We found that total costs of persons with DM were almost 4 times higher than total cost of people without DM. Total costs were $77.08 and$281.92 for ND and DM, respectively, with a difference of $204.84.Healthcare use and costs were dramatically higher for people with DM than for people with normal glucose tolerance and, in relative terms, much higher than in developed countries

Characteristics of the study population.

<p>Characteristics of the study population.</p

Flowchart of sample selection process.

<p>Flowchart of sample selection process.</p

Incremental costs for the combined version of the two-part model for DM (previous 90 days).

<p>Incremental costs for the combined version of the two-part model for DM (previous 90 days).</p

Total resource use and direct costs per person (last 90 days) for the entire population.

<p>(int $) (unadjusted).</p

Impact of DM on total costs.

<p>Impact of DM on total costs.</p

Anti-diabetic and anti-hypertensive treatment in intervention group and in control group at baseline and at 12-month follow-up (FU).

<p>Anti-diabetic and anti-hypertensive treatment in intervention group and in control group at baseline and at 12-month follow-up (FU).</p

Evolution of HbA1c levels between baseline and 12 months–levels in % and 95% confidence interval.

<p>Evolution of HbA1c levels between baseline and 12 months–levels in % and 95% confidence interval.</p

Changes in biomedical outcomes from baseline to 12 months.

<p>The ST2EP trial in Mali. Data are mean (CI 95%).</p