10 research outputs found
Aspects cliniques et thérapeutiques des anomalies de la jonction pyélo-urétérale au CHU du point G
Cette Ă©tude a Ă©tĂ© faite pour analyser les aspects cliniques et thĂ©rapeutiques des anomalies de la jonction pyĂ©lo-urĂ©tĂ©rale. Etude transversale et descriptive portant sur 35 cas d'anomalies de la jonction pyĂ©lo-urĂ©tĂ©rale (AJPU) colligĂ©s au service d'Urologie du CHU du Point G durant une pĂ©riode de 4 ans (Janvier 2010 au DĂ©cembre 2014). Les donnĂ©es ont Ă©tĂ© recueillies sur les fiches d'enquĂȘte, les dossiers mĂ©dicaux et les registres du bloc. Les donnĂ©es sociodĂ©mographique, clinique et thĂ©rapeutique ont Ă©tĂ© saisies sur Microsoft Word 2007 et analysĂ©es sur Excel 2007 et SPSS 18.0. 35 cas d'AJPU ont Ă©tĂ© colligĂ©s en 4 ans. La moyenne d'Ăąge Ă©tait de 29,3 ans. La douleur lombaire Ă©tait le motif de consultation le plus frĂ©quent soit 40 %. 20 % des patients ont Ă©tĂ© en consultation pour la premiĂšre fois 10 ans d'Ă©volution symptomatique. Une destruction rĂ©nale avait Ă©tĂ© observĂ©e dans 28,6 %. Le couple Echographie + UIV a permis d'Ă©tablir le diagnostic chez 37,1 %. La complication lithiasique Ă©tait prĂ©sente chez 17,1 % des patients. 51,4 % des patients ont reçu une pyĂ©loplastie Ă ciel ouvert selon Anderson KUSS. L'anomalie de la jonction pyĂ©lo-urĂ©tĂ©rale dans notre Ă©tude a Ă©tĂ© caractĂ©risĂ©e par un retard de consultation avec des complications redoutables. La chirurgie Ă ciel ouvert a Ă©tĂ© le gold standard avec des rĂ©sultats satisfaisants. L'endopyĂ©loplastie, la cure de la jonction coelioscopique sont des chirurgies mini invasives non disponible chez nous mais Ă encourager et Ă intĂ©grer dans l'arsenal thĂ©rapeutique.Pan African Medical Journal 2016; 2
Kyste géant para-urétral feminine
Le kyste gĂ©ant para-urĂ©tral fĂ©minin infectĂ© est rarement rapportĂ© dans la littĂ©rature. Ce kyste est diffĂ©rent du diverticule sous urĂ©tral sur le plan clinique, diagnostique et thĂ©rapeutique. Sa pathogĂ©nie se confond avec celle des diverticules sous urĂ©traux. Son traitement nâest pas bien codifiĂ©, vu sa raretĂ©. Nous rapportons un cas atypique de kyste gĂ©ant para urĂ©tral infectĂ© chez une jeune femme de 26 ans. Le kyste Ă©tait symptomatique et la patiente a eu un traitement chirurgical. Nous discutons les aspects cliniques, diagnostiques et thĂ©rapeutiques de cette entitĂ© rare Ă travers une revue de la littĂ©rature.Key words: Kyste gĂ©ant, para urĂ©tral, fĂ©minin, chirurgi
Etude épidémiologique, clinique et thérapeutique des hydrocÚles dans trois districts sanitaires de la région de Sikasso/Mali: Epidemiological, Clinical and Therapeutic Study of Hydroceles in Three Health Districts in the Sikasso Region / Mali
Context and objective. Hydrocele is one of the most common urogenital manifestations of lymphatic filariasis. It is a common cause of enlarged scrotum in the tropics. This study aims to describe the epidemiological, clinical and therapeutic aspects of hydroceles.
Methods. This cross-sectional descriptive study of hydroceles in three endemic filarial Sikasso areas in Mali was conducted from November 2017 to December 2018. The variables studied were: frequency of hydrocele, age of patients, duration of evolution, type of anesthesia, surgical technique, volume, operative time and postoperative results.
Results. Three hundred fifty-eight patients were operated on in fourteen months. The frequency of hydroceleâs surgery was 31%. Their average age was 47.1 years old (extremes 4 months and 94 years). The duration of evolution was 10.7 years (extremes 6 months and 21 years). The right side was the most affected with 44.1% followed by the left side with 31.3%. Hydrocele was bilateral in 19%. Local anesthesia (with xylocaine 2%) was used in 88%. All patients underwent a successful vaginal resection.
Conclusion. The hydrocele remains a common urological pathology in these endemic areas. The diagnosis is made after a long period of evolution of the disease. Treatment in outpatient surgery is undertaken using local anesthesia. These hydrocele management campaigns should be encouraged to treat the maximum number of patients.
Contexte et objectif. LâhydrocĂšle constitue lâune des manifestations urogĂ©nitales les plus frĂ©quentes de la filariose lymphatique. Elle est une cause frĂ©quente de grosse bourse dans les rĂ©gions tropicales. Lâobjectif de cette Ă©tude est de dĂ©crire les aspects Ă©pidĂ©miologiques, cliniques et thĂ©rapeutiques des hydrocĂšles.
MĂ©thodes. Il sâagissait dâune Ă©tude transversale et descriptive sur les hydrocĂšles, rĂ©alisĂ©e entre novembre 2017 et dĂ©cembre 2018 ; dans trois zones endĂ©miques filariennes dans la rĂ©gion de SIKASSO au Mali. Les variables Ă©tudiĂ©es Ă©taient : la frĂ©quence de lâhydrocĂšle, lâĂąge des patients, la durĂ©e dâĂ©volution, le type dâanesthĂ©sie, la technique chirurgicale, le volume, le temps opĂ©ratoire et les rĂ©sultats postopĂ©ratoires.
RĂ©sultats. Trois cent cinquante-huit patients ont Ă©tĂ© opĂ©rĂ©s en quatorze mois. Lâintervention de lâhydrocĂšle rendait compte de 31% des activitĂ©s chirurgicales. Leur Ăąge moyen Ă©tait de 47,1 ans (extrĂȘmes 4 mois et 94 ans). La durĂ©e dâĂ©volution Ă©tait de 10,7 ans (extrĂȘmes de 6 mois et 21 ans). Le testicule droit Ă©tait le plus touchĂ© (44,1 %) suivi du cĂŽtĂ© gauche (31,3%). LâhydrocĂšle Ă©tait bilatĂ©rale dans 19 %. LâanesthĂ©sie locale Ă la xylocaĂŻne 2 % a Ă©tĂ© rĂ©alisĂ©e dans 88%. La rĂ©section vaginale a Ă©tĂ© rĂ©alisĂ©e chez tous les patients avec succĂšs.
Conclusion. LâhydrocĂšle reste une pathologie urologique frĂ©quente en zone dâendĂ©mie filarienne. Le diagnostic se fait aprĂšs une longue durĂ©e dâĂ©volution de la maladie. Le traitement en chirurgie ambulatoire rĂ©alisĂ©e sous anesthĂ©sie locale a montrĂ© des rĂ©sultats satisfaisants. Ces campagnes de prise en charge de lâhydrocĂšle sont Ă encourager pour pouvoir traiter le maximum de patients
Two-Year Scale-Up of Seasonal Malaria Chemoprevention Reduced Malaria Morbidity among Children in the Health District of Koutiala, Mali
International audienceBackground: Previous controlled studies demonstrated seasonal malaria chemoprevention (SMC) reduces malaria morbidity by >80% in children aged 3-59 months. Here, we assessed malaria morbidity after large-scale SMC implementation during a pilot campaign in the health district of Koutiala, Mali.Methods: Starting in August 2012, children received three rounds of SMC with sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ). From July 2013 onward, children received four rounds of SMC. Prevalence of malaria infection, clinical malaria and anemia were assessed during two cross-sectional surveys conducted in August 2012 and June 2014. Investigations involved 20 randomly selected clusters in 2012 against 10 clusters in 2014.Results: Overall, 662 children were included in 2012, and 670 in 2014. Children in 2014 versus those surveyed in 2012 showed reduced proportions of malaria infection (12.4% in 2014 versus 28.7% in 2012 (p = 0.001)), clinical malaria (0.3% versus 4.2%, respectively (p < 0.001)), and anemia (50.1% versus 67.4%, respectively (p = 0.001)). A propensity score approach that accounts for environmental differences showed that SMC conveyed a significant protective effect against malaria infection (IR = 0.01, 95% CI (0.0001; 0.09), clinical malaria (OR = 0.25, 95% CI (0.06; 0.85)), and hemoglobin concentration (ÎČ = 1.3, 95% CI (0.69; 1.96)) in 2012 and 2014, respectively.Conclusion: SMC significantly reduced frequency of malaria infection, clinical malaria and anemia two years after SMC scale-up in Koutiala
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Effect of community health worker home visits on antenatal care and institutional delivery: an analysis of secondary outcomes from a cluster randomised trial in Mali.
IntroductionThough community health workers (CHWs) have improved access to antenatal care (ANC) and institutional delivery in different settings, it is unclear what package and delivery strategy maximises impact.MethodsThis study reports a secondary aim of the Proactive Community Case Management cluster randomised trial, conducted between December 2016 and April 2020 in Mali. It evaluated whether proactive home visits can improve ANC access at a population level compared with passive site-based care. 137 unique village clusters, covering the entire study area, were stratified by health catchment area and distance to the nearest primary health centre. Within each stratum, clusters were randomly assigned to intervention or control arm. CHWs in intervention clusters proactively visited all homes to provide care. In the control clusters, CHWs provided the same services at their fixed community health post to care-seeking patients. Pregnant women 15-49 years old were enrolled in a series of community-based and facility-based visits. We analysed individual-level annual survey data from baseline and 24-month and 36-month follow-up for the secondary outcomes of ANC and institutional delivery, complemented with CHW monitoring data during the trial period. We compared outcomes between: (1) the intervention and control arms, and (2) the intervention period and baseline.ResultsWith 2576 and 2536 pregnancies from 66 and 65 clusters in the intervention and control arms, respectively, the estimated risk ratios for receiving any ANC was 1.05 (95% CI 1.02 to 1.07), four or more ANC visits was 1.25 (95% CI 1.08 to 1.43) and ANC initiated in the first trimester was 1.11 (95% CI 1.02 to 1.19), relative to the controls; no differences in institutional delivery were found. However, both arms achieved large improvements in institutional delivery, compared with baseline. Monitoring data show that 19% and 2% of registered pregnancies received at least eight ANC contacts in the intervention and control arms, respectively. Six clusters, three from each arm had to be dropped in the last 2 years of the trial.ConclusionsProactive home visits increased ANC and the number of antenatal contacts at the clinic and community levels. ANC and institutional delivery can be increased when provided without fees from professional CHWs in upgraded primary care clinics.Trial registration numberNCT02694055
Prevalence of molecular markers of resistance to sulphadoxine, pyrimethamine and amodiaquine at baseline and post-SMC in the SMC population.
<p>Prevalence of molecular markers of resistance to sulphadoxine, pyrimethamine and amodiaquine at baseline and post-SMC in the SMC population.</p
Demographic, clinical, and laboratory participant characteristics in SMC and non-SMC population.
<p>Demographic, clinical, and laboratory participant characteristics in SMC and non-SMC population.</p
Prevalence of molecular markers of resistance to sulphadoxine, pyrimethamine and amodiaquine at baseline and post intervention period in Non-SMC patient population.
<p>Prevalence of molecular markers of resistance to sulphadoxine, pyrimethamine and amodiaquine at baseline and post intervention period in Non-SMC patient population.</p
Prevalence of molecular markers of resistance to sulphadoxine, pyrimethamine and amodiaquine at post-SMC in the SMC population <i>vs</i>. concurrent Non-SMC patient population.
<p>Prevalence of molecular markers of resistance to sulphadoxine, pyrimethamine and amodiaquine at post-SMC in the SMC population <i>vs</i>. concurrent Non-SMC patient population.</p